Statins, percutaneous coronary intervention and myocardial infarction

Peri-procedural myocardial infarction occurs in up to 40% of otherwise successful percutaneous coronary intervention (PCI) procedures and such patients have a worse long term prognosis than those who do not have this complication. Statins administered at the time of PCI, particularly before the procedure, have been shown to reduce the risk of myocardial infarction during PCI, but the applicability of this treatment may be limited because of the widespread use of statins in patients with existing coronary artery disease, or in those at risk of developing the disease. The results of a study are reported in this issue of the journal in which a single dose of atorvastatin is given prior to PCI to patients already taking a statin, and shows a significant reduction in the risk of peri-procedural myocardial infarction. It may be that a single supplemental dose of a statin at PCI to all patients could confer clinical benefit.