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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction

K Priti1, Anand Agrawal1, Bhanwar L Ranwa1

  • 1Dept of cardiology, JLN hospital, Ajmer, Rajasthan, 305001, India.

Indian Heart Journal
|August 21, 2017
PubMed

Insights

High-dose atorvastatin did not significantly reduce major adverse cardiac events (MACEs) in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. However, it improved ST-segment resolution, despite increased myalgia.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Statin therapy is proven to reduce major adverse cardiac events (MACEs) in acute coronary syndromes.
  • Limited randomized studies exist on statin therapy for Indian patients with ST-segment elevation myocardial infarction (STEMI).

Purpose of the Study:

  • To compare the efficacy and safety of high-dose (80 mg) versus low-dose (10 mg) atorvastatin in Indian STEMI patients undergoing thrombolysis.
  • To evaluate the impact on 30-day MACE and ST-segment resolution.

Main Methods:

  • 1027 eligible STEMI patients were randomized to receive either 80 mg or 10 mg of atorvastatin.
  • The primary endpoint was the 30-day incidence of MACE, including death, myocardial infarction, NSTE-ACS, revascularization, and stroke.
  • Secondary endpoints included ST-segment resolution and individual MACE components.

Main Results:

  • No significant difference in 30-day MACE between high-dose and low-dose atorvastatin groups (8.79% vs. 9.32%, P=0.764).
  • High-dose atorvastatin showed significantly improved ST-segment resolution (45.90% vs. 37.67%, P=0.008).
  • Increased incidence of myalgia was observed in the high-dose group (18.06% vs. 7.57%, P=0.0001).

Conclusions:

  • High-dose atorvastatin did not significantly reduce MACE in STEMI patients undergoing thrombolysis.
  • High-dose atorvastatin improved immediate coronary flow, indicated by ST-segment resolution.
  • The benefits of high-dose statins must be balanced against increased myalgia, potential drug discontinuation, and cost in the Indian population.
Abstract

Keywords:
MyalgiaST elevation myocardial infarctionStatinThrombolysis

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