Does statin pretreatment improve myocardial perfusion in STEMI patients undergoing PPCI?
Statin pretreatment prior to primary PCI in STEMI patients significantly improves epicardial coronary blood flow.
BACKGROUND: To achieve sufficient myocardial perfusion in ST-segment elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PPCI), many adjunctive therapies have been proposed. Previous trials have reported variances in myocardial perfusion improvement for statin pretreatment, which made it inconvincible to confirm the beneficial effects of statins. Therefore, we performed a systematic review and meta-analysis to determine whether statin pretreatment was effective in improving myocardial perfusion. HYPOTHESIS: Statin pretreatment could improve myocardial perfusion in STEMI patients undergoing PPCI. METHODS: We searched the PubMed, Web of Knowledge, and the Cochrane Library databases for studies evaluating the impact of statin pretreatment on myocardial perfusion in STEMI patients receiving PPCI. RESULTS: Twelve trials were finally included in our meta-analysis. There were no significant differences in patients' baseline characteristics between the statin pretreatment and control groups. Overall pooled analysis showed that patients in the statin pretreatment groups had significantly better epicardial coronary blood flow (measured by Thrombosis in Myocardial Infarction TIMI grade, odds ratio OR: 0.49, 95% confidence interval CI: 0.28 to 0.84; measured by corrected TIMI frame count, mean difference: -5.63; 95% CI: -9.66 to -1.6). A trend toward myocardial tissue level perfusion improvement was seen in the statin pretreatment arm rather than the control arm (measured by myocardial blush grade, OR: 0.74; 95% CI: 0.50 to 1.09). CONCLUSIONS: This present meta-analysis suggests that statin pretreatment might be effective in improving myocardial perfusion in STEMI patients.
Lyu et al. (2013) studied this question.