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Atorvastatin for Reduction of Myocardial Damage During Angioplasty
ARMYDA Trial Atorvastatin for Reduction of Myocardial Damage During Angioplasty Pasceri V, et al Circulation 2004;110:674-8
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Randomized, double-blind
ARMYDA Trial 153 patients scheduled for elective PCI irrespective of baseline lipid levels Randomized, double-blind Atorvastatin 40 mg/d n=76 Placebo n=77 Treatment for 7 days Primary Endpoint: Occurrence of MI, defined as a post-procedural increase of CK-MB >2 times above ULN Circulation 2004;110:674-8
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ARMYDA Trial Post-procedure MI (>2x ULN)
Primary endpoint of post-procedure MI (CKMB>2x ULN) ↓ in atorvastatin group vs placebo (Figure) Presence of markers >1x ULN also ↓ in atorvastatin arm: CKMB 12% vs 35%, p=0.001; troponin I 20% vs 48% p=0.0004; myoglobin 22% vs 51%, p=0.0005 Circulation 2004;110:674-8
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ARMYDA Trial Peak CK-MB Peak Troponin I p = 0.007 p = 0.0008 ng/mL
Circulation 2004;110:674-8
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ARMYDA Trial Among patients undergoing elective PCI irrespective of baseline lipid levels, pre-treatment with atorvastatin was associated with a reduction in markers of myocardial injury post-procedure LIPS trial showed reduction in long-term cardiac events associated with statin use in patients undergoing PCI; however, statin therapy was initiated post-procedure and effect on early myocardial injury was not evaluated Mechanism of action for reduction of myocardial injury unclear but may be related to anti-inflammatory effect of statins Further evaluation warranted
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