CARDIOMARKERS EVALUATION AND MYOCARDIAL ASSESSMENT IN PATIENTS WITH RECANALIZATION OF CHRONIC TOTAL OCCLUSIONS USING HIGH DOSE ATORVASTATIN LOADING

Aim. To assess the effects of high dose atorvastatin loading on the reduction of the rate of myocardial infarction associated with percutaneous coronary interventions and to estimate functional state of myocardium in patients with recanalization of chronic total occlusions in coronary arteries.

Methods. 82 patients who underwent recanalization of chronic total occlusions in coronary arteries were enrolled in the study. The study group included 38 patients who received atorvastatin 80 mg before surgery. The control group consisted of 44 patients who did not receive atorvastatin. Troponin I and CPK-MB fraction were measured in both groups 1 day prior and 24 hours after percutaneous coronary intervention. Functional parameters of the myocardium were estimated with echocardiography 1 day before and 24 hours after percutaneous coronary intervention.

Results. 3 patients (7.9%) in the study group demonstrated moderate elevation of troponin I levels. 11 (25%) patients in the control had over 5-fold increase from the baseline in troponin I levels. 24 hours after percutaneous coronary intervention, elevated CPK-MB was found in 3 (7.9%) patients from the study group and in 16 (36.4%) patients from the control group. There were no statistically significant differences found in echocardiography parameters between the groups.

Conclusion. Atorvastatin 80 mg has a protective effect and prevents periprocedural myocardial ischemia. However, it does not produce any effects on central hemodynamic parameters in the immediate postoperative period. 

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