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Atorvastatin pretreatment, ST-segment resolution and long-term prognosis for ST-segment elevation myocardial

Chao Wu1, Pei Gao2,3, Tiange Chen4

  • 1Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.

International Journal of Cardiology. Heart & Vasculature
|October 2, 2025
PubMed

Insights

Atorvastatin pretreatment before primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) improves myocardial reperfusion. This pretreatment is also linked to reduced major adverse cardiovascular events (MACE) over two years.

Area of Science:

  • Cardiology
  • Pharmacology
  • Interventional Cardiology

Background:

  • The role of statin pretreatment before primary PCI in STEMI patients regarding myocardial reperfusion and prognosis is not well-established.
  • This study investigates the impact of atorvastatin pretreatment on ST-segment resolution (STR) and long-term clinical outcomes in STEMI patients undergoing primary PCI.

Purpose of the Study:

  • To evaluate the efficacy of atorvastatin pretreatment in improving myocardial reperfusion, specifically ST-segment resolution (STR).
  • To assess the association of atorvastatin pretreatment with 2-year major adverse cardiovascular events (MACE) in STEMI patients undergoing primary PCI.

Main Methods:

  • A propensity score-matched analysis was conducted using data from the China Acute Myocardial Infarction Registry.
  • 2426 STEMI patients undergoing primary PCI were analyzed, with 1213 in the atorvastatin pretreatment group and 1213 in the control group.

Main Results:

  • Atorvastatin pretreatment significantly improved ST-segment resolution (STR < 50%: 13% vs 21%, adjusted HR: 0.53).
  • Pretreated patients showed significantly lower 2-year MACE rates (6.9% vs 8.7%, adjusted HR: 0.68).
  • Benefits were observed across multiple patient subgroups.

Conclusions:

  • A single dose of atorvastatin pretreatment before primary PCI significantly enhances myocardial reperfusion in STEMI patients.
  • Atorvastatin pretreatment may be associated with improved long-term clinical benefits, warranting further investigation in randomized trials.
Abstract

Keywords:
AtorvastationPretreatmentPrimary PCISTEMI

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