ATORVASTATIN COMBINED WITH PROBUCOL CAN REDUCE SERUM URIC ACID'S LEVEL DURING PERIOPERATIVE PERIOD OF INTERVENTION

Abstract

Aims: Contrast induced acute kidney injury (CIAKI) is reported to be the leading cause of acute renal failure. Uric acid has ever been considered as one of CIAKI's risk factors. Atorvastatin and Probucol can improve CIAKI. However, there are few studies on whether their improving effect is associated with decreasement of uric acid. Methods and results: 208 cases admitted for coronary angioplasty were randomly assigned into three groups: standard combined treatment group (n=55): atorvastatin 20 mg qn and probucol 0.25 g/tid, without loading dose before angioplasty; intensive combined treatment group (n=79): atorvastatin 40 mg qn and probucol 0.25 g tid, with a loading dose of atorvastatin 40 mg and probucol 0.5 g 2 hours before the angioplasty; intensive atorvastatin therapy group (n=74): atorvastatin 40 mg qn, with a loading dose of atorvastatin 40 mg 2 hours before the angioplasty. Patients' blood urea nitrogen (BUN), serum creatinine (Scr), serum uric acid(SUA) were measured and their estimated glomerular filtration rate (eGFR) were evaluated by MDRD method, 24 hours before and after the angioplasty procedure. After the procedure, BUN in all the three groups decreased; Scr of standard combined treatment groupandintensive atorvastatin therapy groupincreased significantly, while eGFR decreased in the standard combined treatment group (P<0.05); there were no significant differences in Scr and eGFRof intensive combined treatment group (P>0.05); SUA in standard combined treatment groupandintensive combined treatment groupdecreased significantly after operation (P<0.05), while there were no significant differences in intensive atorvastatin therapy group (P>0.05). For the subgroup of hypertensive patients, Scr of standard combined treatment groupand intensive atorvastatin therapy group increased significantly (P<0.05), while eGFR of the two groups decreased (P<0.05); in intensive combined treatment group, BUN and SUA decreasedmarkedly (P<0.05), Scr and eGFR showed no significant changes. Conclusions: Combination treatment of atorvastatin and probucol before an intervention could reduce perioperative serumuric acid level, the intensive combined treatment can improve CIAKI. For hypertensive patients, a combination and intensive treatment could not only reduce serumuric acid level, but also improve the CIAKI.