Why the study?
The study was designed to compare the effects of single high-dose rosuvastatin versus atorvastatin preloading prior to primary PCI in patients presenting with STEMI.
Does high-dose atorvastatin or rosuvastatin preloading improve myocardial perfusion in STEMI patients undergoing primary PCI?
Does high-dose atorvastatin or rosuvastatin preloading improve myocardial perfusion in STEMI patients undergoing primary PCI?
High-dose statin preloading prior to primary PCI in STEMI patients improves microvascular myocardial perfusion and reduces myocardial injury compared to no statin treatment.
High-dose statin preloading before primary PCI improves perfusion and reduces injury in STEMI; extends evidence for routine preloading.
The aim of this study was to compare the effect of a single high-dose rosuvastatin versus atorvastatin preloading in ST-elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PCI.) Methods: A total of 99 patients presented with STEMI and were randomly divided into three groups—a control group (n = 33) with no statin treatment, an atorvastatin group (n = 33) with a single 80 mg atorvastatin dose and the rosuvastatin group (n = 33) with a single 40 mg rosuvastatin dose in the emergency room (ER) prior to PCI. Post-interventional thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) were recorded, and ST-segment resolution was measured. Results: CTFC was significantly lower for the atorvastatin group (p-value < 0.01) than in the control group. A final TIMI flow grade 3 was achieved in 32 (97.0%) patients in the rosuvastatin group and 28 (84.8%) patients in the atorvastatin group compared with only 25 (75.8%) patients in the control group (p = 0.014). Peak CK-MB in the rosuvastatin group (263.2 [207.2−315.6]) and the atorvastatin group (208 [151.0−314.1]) was lower compared to that in the control group (398.4 [303.9−459.3]); p < 0.001. Conclusions: A single extensive dose of lipophilic atorvastatin prior to primary PCI in STEMI patients showed better improvement in microvascular myocardial perfusion compared to hydrophilic rosuvastatin.
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Adel et al. (2022) studied this question.
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