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Effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation in patients with ST-segment elevation

Langping Zhou1, Xiangming Hu1,2, Haotian Zhang1

  • 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

The Journal of International Medical Research
|June 28, 2023
PubMed

Insights

Atorvastatin improved coronary microcirculatory perfusion in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (pPCI), unlike rosuvastatin. This suggests atorvastatin may be more effective for this patient group.

Area of Science:

  • Cardiology
  • Pharmacology
  • Interventional Cardiology

Background:

  • Dysfunctional coronary circulation is a concern in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI).
  • Limited evidence exists on the comparative effects of different statins on coronary microcirculation in these patients.

Purpose of the Study:

  • To compare the efficacy of atorvastatin versus rosuvastatin in improving dysfunctional coronary circulation in STEMI patients post-pPCI.
  • To evaluate the impact of statin therapy on coronary microvascular function.

Main Methods:

  • Retrospective study of 597 STEMI patients who underwent pPCI.
  • Dysfunctional coronary circulation assessed using Thrombolysis In Myocardial Infarction (TIMI) grade and TIMI Myocardial Perfusion Grade (TMPG).
  • Logistic regression analysis to determine the effect of statin type on coronary microcirculation.

Main Results:

  • No significant difference in TIMI no/slow reflow between atorvastatin and rosuvastatin groups.
  • Significantly lower incidence of TMPG no/slow reflow with atorvastatin (44.58%) compared to rosuvastatin (57.69%).
  • Rosuvastatin was associated with increased odds of TMPG no/slow reflow (OR 1.72-1.73). No difference in clinical outcomes.

Conclusions:

  • Atorvastatin demonstrates superior outcomes in improving coronary microcirculatory perfusion compared to rosuvastatin in STEMI patients undergoing pPCI.
  • These findings highlight potential differences in statin effects on microvascular function post-MI.
Abstract

Keywords:
AtorvastatinST-segment elevation myocardial infarctioncoronary circulationhigh thrombus burdenprimary percutaneous coronary interventionrosuvastatin

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