High Dose Statin as Upstream Therapy and the Frequency of Slow-Flow Phenomenon in Patients Undergoing Primary PCI or Immediate Invasive Therapy

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, necessitating effective treatment strategies. High-dose statin therapy has emerged as a potentially superior approach to improving coronary blood flow and reducing the slow-flow phenomenon, a common complication following percutaneous coronary intervention (PCI), compared to standard-dose statin therapy. Objective: This study aimed to evaluate the efficacy of high-dose statin therapy as an upstream treatment in enhancing coronary blood flow and reducing the incidence of the slow-flow phenomenon in patients undergoing primary PCI or immediate invasive therapy for acute myocardial infarction (AMI). Methods: In a prospective observational study conducted between February 2023 and January 2024, 95 patients with AMI scheduled for primary PCI or urgent treatment were enrolled and divided into two groups: high-dose statin (n=48) and standard-dose statin (n=47). Group A received high-dose atorvastatin before PCI, while Group B was given the standard statin dosage. Baseline characteristics, clinical parameters, coronary angiography findings, and adverse events were recorded. The primary outcome was the incidence of the slow-flow phenomenon, assessed using Thrombolysis in Myocardial Infarction (TIMI) flow grades. Statistical analysis was performed using SPSS version 25. Results: The high-dose statin group showed a significant reduction in the incidence of the slow-flow phenomenon post-PCI (10.4% in Group A vs. 31.9% in Group B, p=0.014) and improved TIMI flow grades. No significant differences were found in baseline characteristics or clinical parameters between the groups. Adverse events were comparable between both groups. Conclusion: High-dose statin therapy prior to PCI significantly reduces the slow-flow phenomenon and improves coronary blood flow in patients with AMI, supporting its use as an effective upstream therapy in CAD management. Further large-scale studies are warranted to confirm these findings and explore the long-term benefits of high-dose statin therapy in diverse populations.