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Effect of High Dose Rosuvastatin Loading before Primary Percutaneous Coronary Intervention on Infarct Size in

Ji Won Kim1, Kyeong Ho Yun1, Eun Kyoung Kim1

  • 1Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.

Korean Circulation Journal
|March 22, 2014
PubMed

Insights

High-dose rosuvastatin loading before primary percutaneous coronary intervention (PCI) significantly reduced infarct size in ST-segment elevation myocardial infarction (STEMI) patients. This intervention improved microvascular myocardial perfusion, leading to better cardiac outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • High-dose statin loading before percutaneous coronary interventions (PCI) is known to reduce myocardial damage in stable angina and acute coronary syndrome.
  • Limited data exists on the efficacy of rosuvastatin loading in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI.

Purpose of the Study:

  • To evaluate the effect of high-dose rosuvastatin loading prior to primary PCI on infarct size and myocardial perfusion in STEMI patients.
  • To compare infarct size, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count, and myocardial blush grade (MBG) between patients receiving rosuvastatin and a control group.

Main Methods:

  • A total of 475 STEMI patients undergoing primary PCI were studied.
  • The statin group (n=208) received 40 mg rosuvastatin loading before primary PCI, while the control group (n=267) received no statin pretreatment.
  • Infarct size, corrected TIMI frame count, and MBG were assessed using single-photon emission computed tomography (SPECT) with technetium 99m tetrofosmin at median 3 days post-PCI.

Main Results:

  • The statin group exhibited a significantly smaller infarct size (19.0±15.9% vs. 22.9±16.5%, p=0.009) compared to the control group.
  • Patients receiving rosuvastatin showed a lower corrected TIMI frame count (28.2±19.3 vs. 32.6±21.4, p=0.020) and a higher MBG (2.49±0.76 vs. 2.23±0.96, p=0.001).
  • Multivariate analysis identified rosuvastatin loading as an independent predictor of reduced infarct size (OR 0.61).

Conclusions:

  • High-dose rosuvastatin loading before primary PCI is effective in reducing infarct size in STEMI patients.
  • The benefit is attributed to improved microvascular myocardial perfusion.
  • Rosuvastatin loading represents a valuable strategy to mitigate myocardial damage in the context of primary PCI for STEMI.
Abstract

Keywords:
AngioplastyHydroxymethylglutaryl-CoA Reductase inhibitorsMyocardial infarctionStents

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