Korean Circulation Journal

  • 제44권2호
  • /
  • Pages.76-81
  • /
  • 2014
  • /
  • 1738-5520(pISSN)
  • /
  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

Effect of High Dose Rosuvastatin Loading before Primary Percutaneous Coronary Intervention on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction

  • Kim, Ji Won (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Yun, Kyeong Ho (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Kim, Eun Kyoung (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Kim, Yong Cheol (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Joe, Dai-Yeol (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Ko, Jum Suk (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Rhee, Sang Jae (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Lee, Eun Mi (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Yoo, Nam Jin (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Kim, Nam-Ho (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Oh, Seok Kyu (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital) ;
  • Jeong, Jin-Won (Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital)
  • 투고 : 2013.11.12
  • 심사 : 2013.12.30
  • 발행 : 2014.02.28
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: High dose rosuvastatin loading before percutaneous coronary interventions (PCI) reduces the myocardial damage and the incidence of adverse cardiac events in patients with stable angina and acute coronary syndrome. However, no studies are present yet about rosuvastatin loading in patients with ST-segment elevation myocardial infarction (STEMI) in a primary PCI setting. Subjects and Methods: A total of 475 patients who underwent primary PCI for STEMI were studied. The study population was divided into two groups with 208 patients in the statin group=40 mg rosuvastatin loading before primary PCI and 267 patients in the control group=no statin pretreatment. At median 3 days after PCI a single-photon emission computed tomography (SPECT) was performed with technetium 99m tetrofosmin For this study were compared infarct size, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count and the myocardial blush grade (MBG) between the both groups. Results: Baseline clinical and procedural characteristics were similar between the groups. Infarct size, as assessed by SPECT, was significantly smaller ($19.0{\pm}15.9%$ vs. $22.9{\pm}16.5%$, p=0.009) in the statin group than in the control group. Patients of the statin group showed a lower corrected TIMI frame count ($28.2{\pm}19.3$ vs. $32.6{\pm}21.4$, p=0.020), and higher MBG ($2.49{\pm}0.76$ vs. $2.23{\pm}0.96$, p=0.001) than the patients of the control group. The multivariate analysis revealed that rosuvastatin loading {odds ratio (OR) 0.61}, pain to balloon time (OR 2.05), anterior myocardial infarction (OR 3.89) and final the MBG (OR 2.93) were independent predictors of a large infarct size. Conclusion: A high dose rosuvastatin loading before the primary PCI reduced the infarct size by microvascular myocardial perfusion improvement.

키워드

참고문헌

  1. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383-9.
  2. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med 1995;333:1301-7. https://doi.org/10.1056/NEJM199511163332001
  3. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med 1996;335:1001-9. https://doi.org/10.1056/NEJM199610033351401
  4. Hong YJ, Jeong MH, Lim JH, et al. The prognostic significance of statin therapy according to the level of C-reactive protein in acute myocardial infarction patients who underwent percutaneous coronary intervention. Korean Circ J 2003;33:891-900. https://doi.org/10.4070/kcj.2003.33.10.891
  5. Ridker PM, Danielson E, Fonseca FA, et al. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009;373:1175-82. https://doi.org/10.1016/S0140-6736(09)60447-5
  6. Patti G, Pasceri V, Colonna G, et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. J Am Coll Cardiol 2007;49:1272-8. https://doi.org/10.1016/j.jacc.2007.02.025
  7. Yun KH, Jeong MH, Oh SK, et al. The beneficial effect of high loading dose of rosuvastatin before percutaneous coronary intervention in patients with acute coronary syndrome. Int J Cardiol 2009;137:246-51. https://doi.org/10.1016/j.ijcard.2008.06.055
  8. Briguori C, Visconti G, Focaccio A, et al. Novel approaches for preventing or limiting events (Naples) II trial: impact of a single high loading dose of atorvastatin on periprocedural myocardial infarction. J Am Coll Cardiol 2009;54:2157-63. https://doi.org/10.1016/j.jacc.2009.07.005
  9. Yun KH, Oh SK, Rhee SJ, Yoo NJ, Kim NH, Jeong JW. 12-month followup results of high dose rosuvastatin loading before percutaneous coronary intervention in patients with acute coronary syndrome. Int J Cardiol 2011;146:68-72. https://doi.org/10.1016/j.ijcard.2010.04.052
  10. Di Sciascio G, Patti G, Pasceri V, Gaspardone A, Colonna G, Montinaro A. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: results of the ARMYDA-RECAPTURE (Atorvastatin for Reduction of Myocardial Damage During Angioplasty) Randomized Trial. J Am Coll Cardiol 2009;54:558-65. https://doi.org/10.1016/j.jacc.2009.05.028
  11. Kim JS, Kim J, Choi D, et al. Efficacy of high-dose atorvastatin loading before primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: the STATIN STEMI trial. JACC Cardiovasc Interv 2010;3:332-9. https://doi.org/10.1016/j.jcin.2009.11.021
  12. van 't Hof AW, Liem A, Suryapranata H, Hoorntje JC, de Boer MJ, Zijlstra F. Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Zwolle Myocardial Infarction Study Group. Circulation 1998;97:2302-6. https://doi.org/10.1161/01.CIR.97.23.2302
  13. Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88. https://doi.org/10.1161/01.CIR.93.5.879
  14. Lev EI, Kornowski R, Vaknin-Assa H, et al. Effect of previous treatment with statins on outcome of patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Am J Cardiol 2009;103:165-9. https://doi.org/10.1016/j.amjcard.2008.08.052
  15. Yun KH, Shin IS, Shin SN, et al. Effect of previous statin therapy in patients with acute coronary syndrome and percutaneous coronary intervention. Korean Circ J 2011;41:458-63. https://doi.org/10.4070/kcj.2011.41.8.458
  16. Hahn JY, Kim HJ, Choi YJ, et al. Effects of atorvastatin pretreatment on infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am Heart J 2011;162:1026-33. https://doi.org/10.1016/j.ahj.2011.08.011
  17. Liu HL, Yang Y, Yang SL, et al. Administration of a loading dose of atorvastatin before percutaneous coronary intervention prevents inflammation and reduces myocardial injury in STEMI patients: a randomized clinical study. Clin Ther 2013;35:261-72. https://doi.org/10.1016/j.clinthera.2013.01.009
  18. Sposito AC, Chapman MJ. Statin therapy in acute coronary syndromes: mechanistic insight into clinical benefit. Arterioscler Thromb Vasc Biol 2002;22:1524-34. https://doi.org/10.1161/01.ATV.0000032033.39301.6A
  19. Lee CW, Park CS, Hwang I, et al. Expression of HMG-CoA reductase in human coronary atherosclerotic plaques and relationship to plaque destabilisation. Heart 2011;97:715-20. https://doi.org/10.1136/hrt.2009.190934
  20. McTaggart F. Comparative pharmacology of rosuvastatin. Atheroscler Suppl 2003;4:9-14.

피인용 문헌

  1. Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials vol.14, pp.None, 2014, https://doi.org/10.1186/s12944-015-0095-1
  2. Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction vol.2016, pp.None, 2014, https://doi.org/10.1155/2016/4945720
  3. The acute impact of high-dose lipid-lowering treatment on endothelial progenitor cells in patients with coronary artery disease—The REMEDY-EPC early substudy vol.12, pp.4, 2014, https://doi.org/10.1371/journal.pone.0172800
  4. Long-term statin use before primary percutaneous coronary intervention improves treatment outcomes of acute myocardial infarction vol.13, pp.4, 2014, https://doi.org/10.3892/etm.2017.4156
  5. Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervent vol.8, pp.1, 2014, https://doi.org/10.1007/s40119-019-0126-5