Effect of rosuvastatin 20 mg pretreatment before percutaneous coronary intervention in patients with acute coronary syndrome

A high loading dose of statin prior to percutaneous coronary intervention (PCI) may reduce periprocedural myocardial injury and major adverse cardiac events (MACE). We evaluated the protective effects of pretreatment with rosuvastatin 20 mg before PCI in patients with acute coronary syndrome (ACS). A total of 2,571 patients from a single-center registry of non-ST segment elevation ACS undergoing PCI between July 2013 and December 2020 were analyzed. After propensity score patching, 1,070 patients who received rosuvastatin pretreatment and 279 patients with no statin pretreatment were identified. The incidences of periprocedural myocardial injury and MACE were compared between the two groups. Cardiac biomarkers and inflammatory markers were assessed at baseline at 6, 24, and 48 hours after PCI. The incidence of periprocedural myocardial injury was similar between the two groups (3.7% vs. 3.6%, P=0.946). Serial changes in cardiac biomarkers, including creatine kinase MB fraction and troponin T, showed no significant differences between the groups. Cumulative cardiac troponin T levels after PCI were also comparable (2.16±5.53 ng/mL vs. 2.16±5.50 ng/mL, P=0.996). The 30-day MACE rate was 2.7% in the rosuvastatin 20 mg pretreatment group and 1.8% in the no-statin group (log-rank P=0.381). In conclusion, a single dose of rosuvastatin 20 mg before PCI did not reduce periprocedural myocardial injury or MACE in patients with ACS.