J Korean Med Sci.
2015 Apr;30(4):435-441. 10.3346/jkms.2015.30.4.435.
Effects of High-dose Atorvastatin Pretreatment in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Study
- Affiliations
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- 1Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jyhahn@skku.edu
- 2Department of Radiology and Center for Imaging Science, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- KMID: 2164451
- DOI: http://doi.org/10.3346/jkms.2015.30.4.435
Abstract
- It is uncertain that atorvastatin pretreatment can reduce myocardial damage in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of atorvastatin pretreatment on infarct size measured by contrast-enhanced magnetic resonance imaging (CE-MRI) in STEMI patients. Patients undergoing primary PCI for STEMI within 12 hr after symptom onset were randomized to an atorvastatin group (n = 30, 80 mg before PCI and for 5 days after PCI) or a control group (n = 37, 10 mg daily after PCI). The primary end point was infarct size evaluated as the volume of delayed hyperenhancement by CE-MRI within 14 days after the index event. The median infarct size was 19% (IQR 11.1%-31.4%) in the atorvastatin group vs. 16.3% (7.2%-27.2%) in the control group (P = 0.27). The myocardial salvage index (37.1% [26.9%-58.7%] vs. 46.9% [39.9-52.4], P = 0.46) and area of microvascular obstruction (1.1% [0%-2.0%] vs. 0.7% [0%-1.8%], P = 0.37) did not differ significantly between the groups. Frequency of the hemorrhagic and transmural infarctions was not significantly different in the 2 groups. Pretreatment with a high-dose atorvastatin followed by further treatment for 5 days in STEMI patients undergoing primary PCI failed to reduce the extent of myocardial damage or improve myocardial salvage.
MeSH Terms
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Adult
Aged
Atorvastatin Calcium/*pharmacology
Electrocardiography
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*pharmacology
Image Enhancement
*Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Infarction/pathology/*therapy
Myocardium/*pathology
*Percutaneous Coronary Intervention
Prospective Studies
Atorvastatin Calcium
Hydroxymethylglutaryl-CoA Reductase Inhibitors
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