ARMYDA Trial Atorvastatin for Reduction of Myocardial Damage

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 Treatment for 7 days Primary Endpoint: g Occurrence of MI, defined as a post-procedural increase of CK-MB >2 times above ULN www. Clinical trial results. org Circulation 2004; 110: 674 -8

ARMYDA Trial Post-procedure MI (>2 x ULN) p = 0. 025 • Primary endpoint of postprocedure MI (CKMB>2 x ULN) ↓ in atorvastatin group vs placebo (Figure) • Presence of markers >1 x 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 www. Clinical trial results. org Circulation 2004; 110: 674 -8

ARMYDA Trial Peak CK-MB Peak Troponin I www. Clinical trial results. org p = 0. 0008 ng/m. L p = 0. 007 Circulation 2004; 110: 674 -8

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 www. Clinical trial results. org