Statins have many favorable pleiotropic effects beyond their lipid-lowering properties.
The aim of this study was to evaluate the impact of long-term statin pretreatment
on the level of systemic inflammation and myocardial perfusion in patients with acute
myocardial infarctions. This was a retrospective study of 1,617 patients with acute
ST-segment elevation myocardial infarctions who underwent primary percutaneous coronary
intervention <12 hours after the onset of symptoms. Angiographic no-reflow was defined
as postprocedural Thrombolysis In Myocardial Infarction (TIMI) flow grade ≤2. Long-term
statin pretreatment was significantly less common in the no-reflow group (6.2% vs
21%, p <0.001). The serum lipid profiles of the groups were similar (p >0.05 for all
parameters). Baseline C-reactive protein levels (10 ± 8.2 vs 15 ± 14 mg/L, p <0.001)
and the frequency of angiographic no-reflow (3.9% vs 14%, p <0.001) were significantly
lower, and myocardial blush grade 3 was more common (50% vs 40%, p = 0.006) in the
statin pretreatment group (n = 306). Moreover, the frequency of complete ST-segment
resolution (>70%) (70% vs 59%, p <0.001) and the left ventricular ejection fraction
were higher (49 ± 7.5% vs 46 ± 8.3%, p <0.001) and peak creatine kinase-MB was lower
(186 ± 134 vs 241 ± 187 IU/L, p <0.001) in the statin-treated group. In conclusion,
long-term statin pretreatment is associated with lower C-reactive protein levels on
admission and better myocardial perfusion after primary percutaneous coronary intervention,
leading to lower enzymatic infarct area and a more preserved left ventricular ejection
fraction. This is a group effect independent of lipid-lowering properties.
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Article Info
Publication History
Published online: December 03, 2010
Accepted:
September 14,
2010
Received in revised form:
September 14,
2010
Received:
August 14,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
