What is the clinical evidence from this study?

Study design: RCT. Population: Acute Coronary Syndrome (n=504). Intervention: Rosuvastatin vs. No statin treatment. Primary outcome: Contrast-induced acute kidney injury (increase in creatinine ≥0.5 mg/dl or ≥25% above baseline within 72 h after contrast) (OR 0.38, 95% CI 0.20 to 0.71, p=0.003).

What question did this study set out to answer?

To assess whether adding on-admission high-dose rosuvastatin to standard preventive measures protects against contrast-induced acute kidney injury in statin-naïve patients with acute coronary syndrome.

May 8, 2026Journal of the American College of Cardiology

Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome

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Key result

High-dose rosuvastatin cuts contrast-induced AKI ~62% compared to no statin.

OR 0.38
95% CI 0.20 to 0.71
P=0.003
n=504

Why the study?

Patients with acute coronary syndrome are at high risk for contrast-induced acute kidney injury, and the role of statin pre-treatment in preventing renal damage remains uncertain.

Does high-dose rosuvastatin prevent contrast-induced acute kidney injury in statin-naïve non-ST elevation ACS patients undergoing early invasive strategy?

Comparison

High-dose rosuvastatin vs no statin treatment

Design

Randomized controlled trial

Follow-up

6 months

Authors

MLMario LeonciniAzienda Usl Toscana Centro ATAnna TosoAzienda Usl Toscana Centro MMMauro MaioliAzienda Usl Toscana Centro

Discussion

Member takes

Implication

High-dose rosuvastatin given on admission to statin-naïve NSTE-ACS patients undergoing early invasive procedures significantly reduces contrast-induced acute kidney injury and improves short-term clinical outcomes.

Key Points

To assess whether adding on-admission high-dose rosuvastatin to standard preventive measures protects against contrast-induced acute kidney injury in statin-naïve patients with acute coronary syndrome.
Conducted a randomized trial (PRATO-ACS; NCT01185938) in 504 consecutive statin-naïve patients with non-ST elevation acute coronary syndrome scheduled for an early invasive strategy.
Patients were randomized to receive rosuvastatin (40 mg on admission, followed by 20 mg/day; n=252) or no statin treatment (n=252).
Contrast-induced acute kidney injury (CI-AKI) was defined as a serum creatinine rise of ≥0.5 mg/dl or ≥25% above baseline within 72 hours of contrast administration.
The incidence of CI-AKI was significantly lower in the rosuvastatin group than in controls (6.7% vs. 15.1%; adjusted OR: 0.38, 95% CI: 0.20 to 0.71; p=0.003).
Thirty-day adverse cardiovascular and renal events occurred in 3.6% of the rosuvastatin group versus 7.9% of controls (p=0.036).
At 6-month follow-up, death or nonfatal myocardial infarction occurred in 3.6% of statin-treated patients versus 7.2% of controls (p=0.07).

Study Design

Type

RCT (n=504)

Randomization

Randomized

Structured PICO

Does high-dose rosuvastatin prevent contrast-induced acute kidney injury in statin-naïve non-ST elevation ACS patients undergoing early invasive strategy?

Population

504 statin-naïve patients with non-ST elevation acute coronary syndrome scheduled for an early invasive strategy, followed for up to 6 months.

Intervention

Rosuvastatin 40 mg on admission, followed by 20 mg/day, in addition to standard preventive measures on-admission.

Comparator

No statin treatment, in addition to standard preventive measures on-admission.

Outcome

Contrast-induced acute kidney injury (CI-AKI), defined as an increase in creatinine concentration of ≥0.5 mg/dl or ≥25% above baseline within 72 h after contrast administration.surrogate

Main Result

Odds Ratio: 0.38 (95% CI 0.2–0.71)

Absolute Event Rate: 6.7% vs 15.1%

p-value: p=0.003

Cite This Study

Leoncini et al. (2013) conducted an RCT in Acute Coronary Syndrome (n=504). Rosuvastatin vs. No statin treatment was evaluated on Contrast-induced acute kidney injury (increase in creatinine ≥0.5 mg/dl or ≥25% above baseline within 72 h after contrast) (OR 0.38, 95% CI 0.20 to 0.71, p=0.003). High-dose rosuvastatin given on admission significantly reduced the incidence of contrast-induced acute kidney injury compared to no statin (6.7% vs. 15.1%; OR 0.38; 95% CI 0.20-0.71; p=0.003).

synapsesocial.com/papers/69fdfee744d6484a6a0392f4 https://doi.org/10.1016/j.jacc.2013.04.105

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Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider