Clinical benefits of statin pretreatment in patients undergoing coronary revascularization

A large number of randomized trials have established the beneficial effects of statins for primary and secondary prevention of coronary artery disease. Statins may improve endothelial function and stabilize atherosclerotic plaques by inhibiting oxidative stress and inflammation. Pretreatment with statins before elective percutaneous coronary intervention reduces periprocedural myocardial infarction in patients with stable angina or acute coronary syndromes. Moreover, an acute reload of atorvastatin even in the context of chronic statin has been associated with a significant reduction within 30 days of major adverse cardiac events after percutaneous coronary intervention. Patients on statins at the time of percutaneous coronary intervention also had a lower incidence of contrast-induced nephropathy, as compared with those that were statin-naive. Finally, atorvastatin pretreatment may prevent the occurrence of atrial fibrillation in patients undergoing elective cardiac surgery. Overall, this evidence may strongly influence the clinical practice of interventional cardiologists and cardiac surgeons.