Key result
Rosuvastatin loading prevents no-reflow vs atorvastatin in STEMI undergoing primary PCI.
Why the study?
No-reflow and low TIMI flow are adverse events during PCI, and the comparative effectiveness of atorvastatin versus rosuvastatin in reducing no-reflow in STEMI patients was unclear.
Does a preprocedural loading dose of rosuvastatin improve TIMI flow and reduce no-reflow compared to atorvastatin in STEMI patients undergoing primary PCI?
RCT (n=280)
Randomly divided
Does a preprocedural loading dose of rosuvastatin improve TIMI flow and reduce no-reflow compared to atorvastatin in STEMI patients undergoing primary PCI?
Absolute Event Rate: 0% vs 51.4%
p-value: p=< 0.001
A preprocedural loading dose of rosuvastatin significantly improved TIMI flow and ST resolution compared to atorvastatin in STEMI patients undergoing primary PCI.
Rosuvastatin loading may reduce no-reflow versus atorvastatin in primary PCI; leaves open need for larger confirmatory trials.
Background: As a promising revascularization therapy, percutaneous coronary intervention (PCI) is widely used in patients with coronary artery disease. No-reflow and low thrombolysis in myocardial infarction (TIMI) flow are two adverse periprocedural events. Objectives: This study aimed to compare the effectiveness of atorvastatin and rosuvastatin in reducing the no-reflow phenomenon in patients undergoing primary PCI. Methods: Following a randomized control design, 280 eligible patients with no history of MI or ischemic heart disease (IHD) with ST-elevation myocardial infarction (STEMI) who were candidates for coronary angioplasty underwent angioplasty from May 2020 to December 2020. Results: Our results showed that TIMI flow III was significantly higher in the rosuvastatin group, while the no-reflow was not seen in this group (P < 0.001). Also, ST resolution after 90 minutes of PCI was significantly better in the rosuvastatin group. Conclusions: This study demonstrated that using a loading dose of rosuvastatin could reduce the no-reflow phenomenon in patients undergoing primary PCI.
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Aslanabadi et al. (2022) conducted an RCT in ST-Elevation Myocardial Infarction (STEMI) (n=280). Rosuvastatin vs. Atorvastatin 80 mg was evaluated on Incidence of no-reflow after PCI (p=< 0.001). A preprocedural 40 mg loading dose of rosuvastatin completely prevented the no-reflow phenomenon (0% vs 51.4%) and resulted in higher rates of normal TIMI III flow (87.1% vs 28.6%) compared to an 80 mg loading dose of atorvastatin in patients with STEMI undergoing primary PCI.
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