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

• Kim EK
• Hahn JY
• Song YB
• Chang SA
• Choi JH
• Choi SH
• Lee SC
• Choe YH
• Lee SH
• Gwon HC

• 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.

Keyword

Atorvastatin; Myocardial Infarction; Percutaneous Coronary Intervention

MeSH Terms

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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