Atorvastatin Pre-Treatment Improves Cardiovascular Outcomes In Patients With Acute Coronary Syndrome Undergoing Coronary Intervention

Main Category: Cardiovascular / Cardiology
Also Included In: Statins;  Cholesterol
Article Date: 26 Mar 2007 - 0:00 PDT

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Researchers from the Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome presented data today at the American College of Cardiology's 56th Annual Scientific Session that shows that short-term pre-treatment with atorvastatin 80 mg and 40 mg reduced the risk of major cardiovascular events at 30 days by 88 percent compared with placebo when given to patients with acute coronary syndrome (ACS) prior to coronary angioplasty or stenting. The ARMYDA-ACS (Atorvastatin for Reduction of MYocardial Damage during Angioplasty-Acute Coronary Syndromes) Randomized Trial is the first controlled trial of pre-treatment with statins before early intervention in patients with ACS. This study will also be published in the March 27th issue of the Journal of the American College of Cardiology.

A total of 170 ACS patients were randomized to receive a double dose of 80 mg of atorvastatin 12 hours before angioplasty or stenting and another 40 mg dose before the procedure (n=85) or placebo (n=85). All patients received long-term atorvastatin treatment (40 mg/day) following the procedure. The incidence of major adverse cardiovascular events (death, myocardial infarction or unplanned revascularization) at 30 days was met in five percent of patients in the atorvastatin group and in 17 percent in the placebo group (p=0.01). Taking into account multiple patient variables that might have influenced the results, atorvastatin pre-treatment reduced the combined risk of one of these major cardiovascular complications by 88 percent (p=0.004). Most of the improvement was accounted for by a significant reduction in the risk of heart attack (a 70 percent reduction).

"This study confirms that treating high-risk patients with high-dose atorvastatin prior to angioplasty or stenting can help reduce the risk of coronary events like heart attack and revascularizations in patients with ACS," said Dr. Germano Di Sciascio, Professor and Chairman of Cardiology and Director of Cardiovascular Sciences, Campus Bio-Medico, University of Rome, Italy. "Cardiologists should now consider high-dose statins prior to interventional procedures. Atorvastatin should be part of the armamentarium of the interventional cardiologist."

ACS is a life-threatening condition covering any group of clinical symptoms compatible with acute myocardial ischemia (MI) and can be characterized by heart attack and/or sudden, severe chest pain. Approximately, 1.6 million Americans are hospitalized for ACS each year and nearly one million ACS patients will have a heart attack each year.

Angioplasty, also known as or percutaneous coronary intervention, encompasses a variety of procedures used to treat patients with blocked arteries. In angioplasty, a thin tube with a balloon or other device on the end is first threaded through a blood vessel in the arm or groin (upper thigh) up to the site of a narrowing or blockage in a coronary artery. Once in place, the balloon is then inflated to push the plaque outward against the wall of the artery, widening the artery and restoring the flow of blood through it. Stents are also used during angioplasty to prop open the artery to also help improve blood flow.

Previous ARMYDA studies have demonstrated:

-- Treatment with atorvastatin 40 mg/day initiated seven days prior to angioplasty significantly reduced the risk of myocardial infarction (MI) compared to placebo in patients with stable angina undergoing elective angioplasty.

-- Treatment with atorvastatin 40 mg reduced the risk of arterial fibrillation by 61 percent in patients undergoing coronary artery bypass grafting (CABG).

The ARMYDA study was conducted independently of Pfizer, Inc, the makers of atorvastatin by researchers at the Campus Bio-Medico University of Rome.