Atorvastatin Reducing Contrast-induced Nephropathy Rate in Patietns With Emergent Percutaneous Coronary Intervention via Improving Heat Shock Protein-90 Expression / 中国循环杂志

ABSTRACT

Objective: To explore the high dose atorvastatin reducing contrast induced nephropathy (CIN) rate in patiens with emergent percutaneous coronary intervention (PCI) via improveing heat shock protein-90 (HSP90) expression with its possible mechanism. Methods: A total of 158 STEMI patients with emergent PCI in our hospital were studied. The patients were randomly divided into 2 groups High dose atorvastatin group, the patients received pre-operative atorvastatin 40 mg,n=80 and Control group, the patients received pre-operative placebo,n=78. The serum creatinin (Scr), creatinine clearance rate (Ccr), blood urea nitrogen (BUN), superoxide dismutase (SOD), malondialdehyde (MDA), nitrogen monoxide (NO), HSP90 mRNA expression and protein concentration and urine α1-microglobulin were examined in all patients and the incidence rates of CIN were compared between 2 groups. Results: Compared with Control group, High dose atorvastatin group had drcreased Scr (68.92 ± 8.80) μmol/L vs (77.25 ± 13.36) μmol/L, MDA (3.88 ± 0.53) nmol/L vs (4.08 ± 0.52) nmol/L and urine α1-micrglobulin (1.38 ± 0.36) mg/dl vs (1.89 ± 1.13 ) mg/dl; increased Ccr (89.71 ± 9.85) ml/min vs (77.28 ± 13.78) ml/ min, SOD (129.52 ± 30.63) U/ml vs (117.66 ± 27.98) U/ml, NO (66.23 ± 29.26) μmol?gprot vs (55.12±27.43) μmol?gprot, allP<0.05. Compared with Control group, High dose atorvastatin group presented higher post-operative HSP90 mRNA expression (0.466 ± 0.158) vs (0.224 ± 0.278 ) and protein concentration (1259.83 ± 121.17) pg/ml vs (1195.0 ± 127.65) pg/ml, allP<0.05. The incidence rate of CIN was lower in High dose atorvastatin group (2.5%) than Control group (10.3%),P<0.05. Conclusion: A high dose atorvastatin administration before emergent PCI may decrease CIN occurrence rate. Atorvastatin may promote HSP90 expression, increase NO produciton, then improve the vascular endothelial function and anti-oxidative ability to protect the renal function in STEMI patients.