Short term high dose atorvastatin for the prevention of contrast-induced nephropathy in patients undergoing computed tomography angiography

BACKGROUND: Statins are shown effective by some studies in preventing contrast-induced nephropathy (CIN). We evaluated the effectiveness of atorvastatin in the prevention of CIN in computed tomography angiography (CTA) candidates. METHODS: This study was conducted on patients referring for elective CTA with normal renal function. Patients received atorvastatin (۸۰ mg/day) or placebo from ۲۴ h before to ۴۸ h after administration of the contrast material. Serum creatinine was measured before and ۴۸ h after contrast material injection. CIN was defined as an increase in serum creatinine level of ≥ ۰.۵ mg/dl or ≥ ۲۵% of the baseline creatinine. RESULTS: A total of ۲۳۶ patients completed the study; ۱۱۵ atorvastatin, ۱۲۱ placebo, mean age = ۵۸.۴۰ ± ۹.۸۰ year, ۶۸.۶% male. Serum creatinine increased after contrast material injection in both the atorvastatin (۱.۰۰ ± ۰.۱۶-۱.۰۲ ± ۰.۱۵ mg/dl, P = ۰.۰۱۷) and placebo groups (۱.۰۳ ± ۰.۱۷-۱.۰۸ ± ۰.۱۸ mg/dl, P < ۰.۰۰۱). Controlling for age, gender, comorbidities, drug history, and baseline serum creatinine level, patients who received atorvastatin experienced less increase in serum creatinine after contrast material injection (beta = ۰.۱۲۷, P = ۰.۰۳۴). However, there was no difference between the atorvastatin and placebo groups in the incidence of CIN (۴.۳ vs. ۵.۰%, P = ۰.۵۳۵). CONCLUSION: In patients undergoing CTA, a short-term treatment with high dose atorvastatin is effective in preventing contrast-induced renal dysfunction, in terms of less increase in serum creatinine level after contrast material injection. Further trials including larger sample of patients and longer follow-ups are warranted.   Keywords: Kidney Diseases, Multidetector Computed Tomography, Contrast Media, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Atorvastatin