*6.2.1 High-dose versus low-dose statins*

High-dose statin therapy may be theoretically more efficacious regarding CIN prevention as a result of acute suppression of inflammatory chemokines [130]. Xie and his colleagues investigated the potency of high-dose statins (simvastatin 80mg, atorvastatin 40 and 80 mg) compared with low-dose statins (simvastatin 20 mg, atorvastatin 10 and 20mg) and revealed that high-dose statins lowered the incidence of CIN [131]. These results were backed up by a recent meta-analysis which showed that high-dose statins (atorvastatin 80 mg, simvastatin 80 mg) in comparison with low-dose statins (atorvastatin 10 and 20 mg, simvastatin 20 mg) in patients having acute coronary syndromes resulted in a relative risk ratio for CIN of 0.46 (4.5 vs 10.2%, p = 0.004); however, it was not of considerable significance among patients performing elective procedures [132]. However, high-dose statins are guideline recommended medications to lower the risk of CIN.
