Atorvastatin Versus Rosuvastatin on Contrast Induced Acute Kidney Injury (PRATO-ACS 2) (PRATO-ACS-2)
Impact of Early High-dose Atorvastatin Versus Rosuvastatin on Contrast Induced Acute Kidney Injury in Unselected Patients With Non- ST Elevation Acute Coronary Syndromes Scheduled for Early Invasive Strategy.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a prospective, single-centre, randomized study, designed to compare the nephro-protective effects of high-dose atorvastatin and high-dose rosuvastatin on the incidence of Contrast Induced-Acute Kidney Injury (CI-AKI). Consecutive statin-naïve patients admitted in the investigators institution for non-ST elevation Acute Coronary Syndrome (NSTE-ACS) and scheduled for early invasive strategy will be eligible.
Patients are randomized into two groups: 1) high-dose rosuvastatin (40 mg on-admission followed by 20 mg/day); 2) high-dose atorvastatin (80 mg on-admission followed by 40 mg/day). Randomization will be performed on-admission by computerized open-label assignment in blinded envelopes used in a consecutive fashion. All patients receive the standard pre-procedural hydration. The primary end-point is the proportion of patients with an increase in serum creatinine of ≥ 0.5 mg/dl or ≥ 25% above baseline within 72 hours after contrast medium administration. The secondary end-points are persistent worsening of renal damage (eGFR reduction >= 25% at 30 days) and cumulative adverse clinical events at follow-up. Specifically: death, myocardial infarction, dialysis, stroke or persistent renal damage at 30 days; death or myocardial infarction at 6 and 12 months.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Prato, Italy, 59100
- Cardiology Division, Prato Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All consecutive statin-naive patients with non ST-elevation acute coronary syndrome admitted to our institution and scheduled for early invasive strategy are considered for enrollment
Exclusion Criteria:
- Current statin treatment
- High-risk features warranting emergency coronary angiography (within 2 hours)
- Acute renal failure or end-stage renal failure requiring dialysis or serum creatinine ≥ 3 mg/dl
- Severe comorbidities which precluded early invasive strategy
- Contraindications to statin treatment
- Contrast media administration within the last 10 days
- Pregnancy
- Refusal of consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Rosuvastatin
Rosuvastatin (40 mg on-admission followed by 20 mg/day) until discharge; then 20 mg/day (10 mg/day if creatinine clearance < 30 ml/min)
|
|
|
Active Comparator: Atorvastatin
atorvastatin (80 mg on-admission followed by 40 mg/day before and after discharge)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Contrast Induced-Acute Kidney Injury
Time Frame: 72 hours
|
Increase in serum creatinine ≥ 0.5 mg/dl or ≥ 25 % within 72 hours of contrast medium exposure
|
72 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Renal function at 30 days
Time Frame: 30 days after discharge
|
Estimation of the glomerular filtration rate in all patients at 30 days
|
30 days after discharge
|
|
Cardiovascular and renal outcome
Time Frame: 30 days, 6 months, 12 months
|
Composite cardiovascular and renal events at follow-up including acute renal failure requiring dialysis, persistent renal damage, all-causes mortality, myocardial infarction or stroke.
|
30 days, 6 months, 12 months
|
|
Anti-inflammatory effect of rosuvastatin and atorvastatin
Time Frame: On admission (baseline), at discharge (after 5 days) & at 30 days
|
High-sensitivity C-reactive protein (hs-CRP)will be measured on admission, at discharge and at 30 days.
|
On admission (baseline), at discharge (after 5 days) & at 30 days
|
|
Lipid-modulatory effects of atorvastatin and rosuvastatin
Time Frame: On admission (baseline), at discharge (after 5 days) & at 30 days
|
Low density lipoprotein (LDL) levels will be determined on admission, at discharge and at 30 days.
|
On admission (baseline), at discharge (after 5 days) & at 30 days
|
|
Myocardial Damage
Time Frame: During hospitalization (average 5 days)
|
Total cardiac biomarkers release during the index event
|
During hospitalization (average 5 days)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Anna Toso, MD, Prato Hospital, Italy
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Kidney Diseases
- Urologic Diseases
- Disease
- Renal Insufficiency
- Syndrome
- Acute Kidney Injury
- Acute Coronary Syndrome
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites
- Anticholesteremic Agents
- Hypolipidemic Agents
- Lipid Regulating Agents
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Atorvastatin
- Rosuvastatin Calcium
Other Study ID Numbers
Other Study ID Numbers
- 472013
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Acute Coronary Syndrome
-
NCT07474441CompletedCKD | Coronary Angiography (CAG) | ACS (Acute Coronary Syndrome)
-
NCT07626840Not yet recruitingAcute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI)
-
NCT07351643Not yet recruitingSGLT2 Inhibitors | ACS (Acute Coronary Syndrome)
-
NCT07390006Not yet recruitingCoronary Artery Disease | Acute Coronary Syndrome/ Myocardial Infarction
-
NCT07422688Enrolling by invitationIschemic Heart Disease | Ischemic Coronary Artery Disease | ACS (Acute Coronary Syndrome)
-
NCT07252388Not yet recruitingAcute Coronary Syndromes | Chronic Coronary Syndromes
-
NCT07592312Not yet recruitingMyocardial Ischemia | Percutaneous Coronary Intervention | Chronic Coronary Syndrome | Coronary Computed Tomography Angiography | Acute Coronary Syndromes (ACS) | Coronary Arteries Disease
-
NCT03797651RecruitingCoronary Artery Disease, Acute Coronary Syndrome
-
NCT07486791RecruitingHF - Heart Failure | ACS (Acute Coronary Syndrome)
-
NCT07259252RecruitingAcute Coronary Syndromes (ACS)
Clinical Trials on Rosuvastatin
-
NCT07619118Not yet recruiting
-
NCT07619131Not yet recruiting
-
NCT07313124CompletedCardiovascular Diseases (CVD)
-
NCT07316608Completed
-
NCT00680017Completed
-
NCT03192579CompletedCoronary Artery Disease Progression
-
NCT01609907CompletedHypertension | Hyperlipidemia
-
NCT02679664Unknown
-
NCT02232360Unknown
-
NCT02445352CompletedPrimary Hypercholesterolemia