Kleber Martins
Sao Lucas and Primavera Hospital, Brazil
Title: A randomized trial of creatine-kinase leak after rosuvastatin in elective Percutaneous Coronary Intervention (clear-PCI)
Biography
Biography: Kleber Martins
Abstract
Objectives: To determine the impact of percutaneous coronary intervention (PCI) performed at the same time of the peak concentration of rosuvastatin to reduce periprocedural myocardial infarction (PMI). Background: Prior studies suggest that a high dose of statin before PCI reduce periprocedural myocardial infarction. However, there is no information regarding the elective PCI performed at the time of the peak of statin concentration to reduce PMI. Methods: From 2011 to 2013, at a single center in Brazil we enrolled 544 patients who underwent elective PCI and after exclusions for baseline biases in clinical and angiographic characteristics, yielding 528 patients, we prospectively randomly assigned them to either a high loading dose of Rosuvastatin before PCI (n=264) or standard treatment (n = 264). After exclusions for biases in procedural characteristics a total of 487 patients underwent to end points analysis. The primary outcome was the incidence of MB fraction of creatine kinase (CK-MB) greater than three times the upper limit of normal. Results: The primary end point occurred in 7.6% in the rosuvastatin and 4.8% in the control group (p = 0.200). There was a higher incidence in elevation of CK-MB than normal baseline in the rosuvastatin (67.1% vs 59.2%, p = 0.701). There was no difference in major adverse event (0% in the rosuvastatin group versus 0.8% in control). Conclusions: The CLEAR-PCI suggest that elective PCI performed at the time of peak concentration of rosuvastatin in patients with stable coronary disease on long-term statin therapy showed no benefit.