Key result
Atorvastatin linked to ~42% lower odds of TMPG no/slow reflow vs rosuvastatin in STEMI.
Why the study?
Evidence regarding therapy for dysfunctional coronary circulation in patients with STEMI undergoing primary PCI is limited.
Does atorvastatin improve dysfunctional coronary circulation in patients with STEMI undergoing pPCI compared to rosuvastatin?
Cohort (n=597)
Yes
Does atorvastatin improve dysfunctional coronary circulation in patients with STEMI undergoing pPCI compared to rosuvastatin?
Effect estimate: OR 1.72 (95% CI 1.17-2.52)
Absolute Event Rate: 44.58% vs 57.69%
Atorvastatin is associated with better coronary microcirculatory perfusion (lower incidence of TMPG no/slow reflow) compared to rosuvastatin in STEMI patients undergoing primary PCI.
May favor atorvastatin for microcirculatory perfusion in STEMI pPCI; hypothesis-generating and requires randomized confirmation.
OBJECTIVE: Evidence of therapy for dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) is limited. This study was performed to compare the effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation. METHODS: This retrospective study enrolled 597 consecutive patients with STEMI who underwent pPCI in 3 centers from June 2016 to December 2019. Dysfunctional coronary circulation was defined by the thrombolysis in myocardial infarction (TIMI) grade and the TIMI myocardial perfusion grade (TMPG). Logistic regression analysis was used to evaluate the impact of different statin types on dysfunctional coronary circulation. RESULTS: The incidence of TIMI no/slow reflow did not differ between the two groups, but the incidence of TMPG no/slow reflow was significantly lower in the atorvastatin than rosuvastatin group (44.58% vs. 57.69%, respectively). After multivariate adjustment, the odds ratio with 95% confidence interval of rosuvastatin was 1.72 (1.17-2.52) for after pretreatment TMPG no/slow reflow and 1.73 (1.16-2.58) for after stenting TMPG no/slow reflow. Atorvastatin and rosuvastatin showed no significant differences in clinical outcomes during hospitalization. CONCLUSIONS: Compared with rosuvastatin, atorvastatin was associated with better coronary microcirculatory perfusion in patients with STEMI who underwent pPCI.
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Zhou et al. (2023) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=597). Atorvastatin vs. Rosuvastatin was evaluated on TMPG no/slow reflow (OR 1.72, 95% CI 1.17-2.52). Atorvastatin was associated with a significantly lower incidence of TMPG no/slow reflow compared to rosuvastatin (44.58% vs. 57.69%; OR for rosuvastatin 1.72, 95% CI 1.17-2.52) in STEMI patients.
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