Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction The STATIN STEMI Trial

被引：155

作者：

Kim, Jung-Sun ^{[1
]}

Kim, Jaedeok ^{[1
]}

Choi, Donghoon ^{[1
]}

Lee, Chan Joo ^{[1
]}

Lee, Sang Hak ^{[1
]}

Ko, Young-Guk ^{[1
]}

Hong, Myeong-Ki ^{[1
]}

Kim, Byoung-Keuk ^{[2
]}

Oh, Seong Jin ^{[2
]}

Jeon, Dong Woon ^{[2
]}

Yang, Joo-Young ^{[2
]}

Cho, Jung Rae ^{[3
]}

Lee, Nam-Ho ^{[3
]}

Cho, Yun-Hyeong ^{[4
]}

Cho, Deok-Kyu ^{[4
]}

Jang, Yangsoo ^{[1
]}

机构：

[1] Yonsei Univ, Coll Med, Severance Hosp, Div Cardiol,Yonsei Cardiovasc Ctr, Seoul 120752, South Korea

[2] Kangnam Sacred Heart Hosp, Div Cardiol, Seoul, South Korea

[3] Ilsan Hosp, Div Cardiol, Natl Hlth Insurance Corp, Koyang, South Korea

[4] Kwandong Univ, Coll Med, Div Cardiol, Dept Internal Med,Myongji Hosp, Goyang, South Korea

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2010年 / 3卷 / 03期

关键词：

statin; percutaneous transluminal coronary angioplasty; acute myocardial infarction; PRIMARY ANGIOPLASTY; EVENTS; REPERFUSION; THERAPY; REDUCTION; DISEASE; DAMAGE;

D O I：

10.1016/j.jcin.2009.11.021

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEN) undergoing primary percutaneous coronary intervention (PCI). Background Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. Methods A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. Results MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 +/- 12.3 vs. 34.1 +/- 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 +/- 0.8 vs. 1.9 +/- 0.8, p = 0.02 and 61.8 +/- 26.2 vs. 50.6 +/- 25.8%, p = 0.01). Conclusions High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEN]; NCT00808717). (J Am Coll Cardiol Intv 2010;3:332-9) (C) 2010 by the American College of Cardiology Foundation

引用

页码：332 / 339

页数：8

共 25 条

[1]

Atorvastatin, administered at the onset of reperfusion, and independent of lipid lowering, protects the myocardium by up-regulating a pro-survival pathway [J].