Author(s): Oduncu V, Tanalp AC, Erkol A, Srma D, Dndar C, , Oduncu V, Tanalp AC, Erkol A, Srma D, Dndar C,
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Abstract 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. Copyright Â© 2011 Elsevier Inc. All rights reserved.
This article was published in Am J Cardiol
and referenced in Cardiovascular Pharmacology: Open Access