ARMYDA研究
Atorvastatin for Reduction of Myocardial Damage During Angioplasty
Pasceri V, et al
Circulation 2004;110:674-8
ARMYDA Trial
Atorvastatin
40 mg/d
n=76
Primary Endpoint:
Occurrence of MI, defined as a post-procedural increase of CK-MB >2 times above ULN
ARMYDA Trial
Circulation 2004;110:674-8
153 patients scheduled for elective PCI irrespective of baseline lipid levels
Randomized, double-blind
Placebo
n=77
Treatment for 7 days
ARMYDA Trial
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
Post-procedure MI
(>2x ULN)
p = 0.025
ARMYDA Trial
Peak CK-MB
p = 0.007
Peak Troponin I
p = 0.0008
Circulation 2004;110:674-8
ng/mL
ng/mL
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