145 - Nephroprotective effect of atorvastatin in patients with acute myocardial infarction (ID 578)
Abstract
Background and Aims
to assess the effect of 48-weeks atorvastatin therapy on the kidneys function in STEMI patients.
Methods
The study included 68 STEMI patients. Patients were randomized into two groups. The 1st group included 38 patients who received atorvastatin 80 mg/day; in the 2nd group - 30 people who took atorvastatin 40 mg/day. At the 7-9th day, after 24 and 48 weeks of follow-up, microalbuminuria (MAU) and a serum creatinine with GFR calculation (CKD-EPI) were performed.
Results
In group 1, MAU initially was 34.9[95%CI 16.6;53.3], after 24 weeks - 10.7[95%CI 3;18.4](p=0.06), 48 weeks - 25.2[95%CI 10.8;39.5]mg (p=0.35). In group 2 MAU baseline - 31.1[95%CI 10.3;51.8], after 24 weeks - 35[95%CI 14.1;55.8](p=0.74), 48 weeks - 13.9[95%CI 9.2;18.6]mg (p=0.14). MAU in group 1 was initially detected in 8 patients (21.1%), after 24 weeks in 1 person (2.6%,p=0.02), after 48 weeks in 4 patients (10.5%,p=0.24). In group 2, microalbuminuria was observed initially in 9 patients (30%), after 24 weeks in 13 patients (43.3%,p=0.3) and after 48 weeks in 5 patients (16.7%,p=0.23). To analyze the GFR dynamics, patients with initial GFR<90 ml/min were identified. In the 1st group, a GFR increasing was detected from 71.1[95%CI 67.2;75.0] to 78.7[95%CI 72.4;84.9] after 24 weeks (p=0.03) and up to 79.6[95%CI 73.0; 86.1]ml/min/1.73 m2 after 48 weeks of follow-up. In group 2, no dynamics of an initially reduced GFR (n=25) was observed: baseline - 74.5[95%CI 69.9;79.1], after 24 weeks - 79.1[95%CI 72.1;86.2] (p=0.21), after 48 weeks - 78.4[95%CI 73.2;83.7] ml/min/1.73m2 (p=0.15).
Conclusions
In STEMI patients, only high-dose long-term therapy with atorvastatin was associated with a nephroprotective effect.
