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Atorvastatin for Reduction of Myocardial Damage During Angioplasty

ARMYDA Trial. Atorvastatin for Reduction of Myocardial Damage During Angioplasty. Pasceri V, et al Circulation 2004;110:674-8. ARMYDA Trial. 153 patients scheduled for elective PCI irrespective of baseline lipid levels Randomized, double-blind. Atorvastatin 40 mg/d n=76. Placebo n=77.

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Atorvastatin for Reduction of Myocardial Damage During Angioplasty

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  1. ARMYDA Trial Atorvastatin for Reduction of Myocardial Damage During Angioplasty Pasceri V, et al Circulation 2004;110:674-8

  2. ARMYDA Trial 153 patients scheduled for elective PCI irrespective of baseline lipid levels Randomized, double-blind • Atorvastatin • 40 mg/d • n=76 • Placebo • n=77 Treatment for 7 days • Primary Endpoint: • Occurrence of MI, defined as a post-procedural increase of CK-MB >2 times above ULN Circulation 2004;110:674-8

  3. ARMYDA Trial Post-procedure MI (>2x ULN) p = 0.025 • 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

  4. ARMYDA Trial Peak CK-MB p = 0.007 Peak Troponin I p = 0.0008 ng/mL ng/mL Circulation 2004;110:674-8

  5. 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

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