한빛사 논문
Jung-Sun Kim MD, PhD⁎, Jaedeok Kim MD⁎, Donghoon Choi MD, PhD⁎, Chan Joo Lee MD⁎, Sang Hak Lee MD, PhD⁎, Young-Guk Ko MD⁎, Myeong-Ki Hong MD, PhD⁎, Byoung-Keuk Kim MD, PhD†, Seong Jin Oh MD†, Dong Woon Jeon MD†, Joo-Young Yang MD, PhD†, Jung Rae Cho MD‡, Nam-Ho Lee MD, PhD‡, Yun-Hyeong Cho MD§, Deok-Kyu Cho MD§, Yangsoo Jang MD, PhD⁎
⁎Division of Cardiology, Yonsei Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
†Division of Cardiology, Kangnam Sacred Heart Hospital, Seoul, Korea
‡Division of Cardiology, National Health Insurance Corporation Ilsan Hospital, Koyang, Korea
§Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea
Reprint requests and correspondence: Dr. Donghoon Choi
Abstract
Objectives
This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) 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 STEMI]; NCT00808717).
논문정보
관련 링크
연구자 ID
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기
해당논문 저자보기