Administration of a Loading Dose of Atorvastatin Before Percutaneous Coronary Intervention Prevents Inflammation and Reduces Myocardial Injury in STEMI Patients: A Randomized Clinical Study

Liu, Huiliang; Yang, Yong; Yang, Shengli; Luo, Jun; Li, Hong; Jing, Limin; Shen, Zhiqi

doi:10.1016/j.clinthera.2013.01.009

Cited by 30 publications

(29 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results were found in the study of Aydin et al . where both rosuvastatin and atorvastatin lowered the inflammation markers in STEMI patients, whereas in another study, a loading dose of atorvastatin was found to reduce inflammatory response and myocardial dysfunction in STEMI patients [67, 68]. The inflammatory response has also been found to be reduced in percutaneous coronary intervention when a short-term high-dose atorvastatin treatment is administered [69].…”

Section: Clinical Evidence Of Statins’ Anti-inflammatory Effectmentioning

confidence: 99%

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

Diamantis

Kyriakos

Quiles-Sánchez

et al. 2017

CCR

172

108

View full text Add to dashboard Cite

Background:Statins have long been used for the protection against coronary artery disease (CAD). Their beneficial effect apart from cholesterol reduction lies in their pleiotropic properties. Emerging evidence from laboratory studies and clinical trials as well have pointed out the pivotal role of inflammation on the initiation and exacerbation of atherosclerosis; a major cause of CAD. Inflam-mation markers such as high sensitivity C-reactive protein and adhesion molecules are shown to in-crease in CAD patients and are used as prognostic tools. It is well known that statins can actually re-duce the circulating levels of these agents slowing therefore the inflammatory process; interestingly not all types have the same outcome.Conclusion:The anti-inflammatory effect of statins on the formation of atherosclerotic plaque and the function of endothelial cells is thus of particular importance as these agents can actually ameliorate CAD prognosis

show abstract

Section: Clinical Evidence Of Statins’ Anti-inflammatory Effectmentioning

confidence: 99%

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

Diamantis

Kyriakos

Quiles-Sánchez

et al. 2017

CCR

172

108

View full text Add to dashboard Cite

show abstract

“…They also reported no improvement of MBG and cTFC after atorvastatin loading before the primary PCI compared with the control group. Liu et al17) recently reported that 80 mg atorvastatin loading followed by 40 mg atorvastatin therapy could reduce the inflammatory response and improve the ejection fraction in patients with STEMI. The present observational study revealed a reduced infarct size, cardiac biomarker elevation and improved cTFC and MBG after 40 mg rosuvastatin loading, but the ejection fraction was not improved.…”

Section: Discussionmentioning

confidence: 99%

Effect of High Dose Rosuvastatin Loading before Primary Percutaneous Coronary Intervention on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction

et al. 2014

View full text Add to dashboard Cite

Background and Objectives High dose rosuvastatin loading before percutaneous coronary interventions (PCI) reduces the myocardial damage and the incidence of adverse cardiac events in patients with stable angina and acute coronary syndrome. However, no studies are present yet about rosuvastatin loading in patients with ST-segment elevation myocardial infarction (STEMI) in a primary PCI setting. Subjects and Methods A total of 475 patients who underwent primary PCI for STEMI were studied. The study population was divided into two groups with 208 patients in the statin group=40 mg rosuvastatin loading before primary PCI and 267 patients in the control group=no statin pretreatment. At median 3 days after PCI a single-photon emission computed tomography (SPECT) was performed with technetium 99m tetrofosmin For this study were compared infarct size, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count and the myocardial blush grade (MBG) between the both groups. Results Baseline clinical and procedural characteristics were similar between the groups. Infarct size, as assessed by SPECT, was significantly smaller (19.0±15.9% vs. 22.9±16.5%, p=0.009) in the statin group than in the control group. Patients of the statin group showed a lower corrected TIMI frame count (28.2±19.3 vs. 32.6±21.4, p=0.020), and higher MBG (2.49±0.76 vs. 2.23±0.96, p=0.001) than the patients of the control group. The multivariate analysis revealed that rosuvastatin loading {odds ratio (OR) 0.61}, pain to balloon time (OR 2.05), anterior myocardial infarction (OR 3.89) and final the MBG (OR 2.93) were independent predictors of a large infarct size. Conclusion A high dose rosuvastatin loading before the primary PCI reduced the infarct size by microvascular myocardial perfusion improvement.

show abstract

“…Inflammation plays an important role in the pathogenesis of plaque instability, and results in plaque rupture or erosion. 5) Pathological and immunohistochemical staining in the ruptured plaques of patients who have died of AMI have shown a preponderance of inflammatory cells. 6,7) Barron and coworkers have reported that a higher leukocyte count is an independent predictor of thrombus burden in patients with STEMI.…”

Section: S T-segment Elevation Myocardial Infarction (Stemi) Ismentioning

confidence: 99%

Plasma Lipoprotein-Associated Phospholipase A2 Level Is an Independent Predictor of High Thrombus Burden in Patients With Acute ST-segment Elevation Myocardial Infarction

Zhang

et al. 2016

Int. Heart J.

View full text Add to dashboard Cite

SummaryLipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent risk factor for plaque rupture and atherothrombotic events. However, the associations between serum Lp-PLA2 level and thrombus burden in ST-segment elevation myocardial infarction (STEMI) patients remain unknown.We consecutively enrolled 351 STEMI patients who underwent primary percutaneous coronary intervention (pPCI). Patients were assigned to a high thrombus burden (HTB) group (n = 230) and a low thrombus burden (LTB) group (n = 121). Baseline data were recorded during hospital admission. Plasma Lp-PLA2 concentration, coronary angiography results, and in-hospital mortality were measured. Plasma Lp-PLA2 level had a high correlation with thrombus burden score (TBS) before pPCI and it was found to be a significant independent predictor of HTB in STEMI patients (P < 0.05). Moreover, TBS, corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC), and plasma Lp-PLA2 level after pPCI in patients with HTB were significantly higher than those in patients with LTB (P < 0.05). Meanwhile, TIMI flow grade (TFG) and TIMI myocardial perfusion grade (TMPG) of HTB patients were markedly lower than those of LTB patients (P < 0.05). Additionally, correlations of plasma Lp-PLA2 level before pPCI with TFG before pPCI and TBS, cTFC, and TMPG after pPCI were modest (P < 0.05). However, the associations of plasma Lp-PLA2 level after pPCI with TFG, TBS, cTFC and TMPG were low (P < 0.05).These results demonstrated that the plasma Lp-PLA2 level before pPCI is an independent predictor of HTB in STEMI patients, resulting in modestly predicting blood flow and myocardial perfusion of the culprit artery. (Int Heart J 2016; 57: 689-696) Key words: Acute myocardial infarction S T-segment elevation myocardial infarction (STEMI) is the most serious type of coronary heart disease and has a high mortality. Accumulated data have indicated that coronary thrombosis in an infarct related artery (IRA) plays a significant role in the development of STEMI. Furthermore, high thrombus burden (HTB) in an IRA can lead to various conditions such as stent thrombosis, distal embolism, slowand non-reflow, and long-term mortality.1-3) Therefore, it is very important to find a good predictive factor of HTB so at an early point in time we can give these patients with HTB some more intensive medical therapy such as enhanced antiplatelet and anticoagulation therapy, despite the recent pharmacological and invasive developments (ie, glycoprotein IIb/IIIa antagonists and thrombectomy) used in primary percutaneous coronary intervention (pPCI) therapy. 3,4)The pathophysiology of STEMI involves inflammatory reaction, endothelium dysfunction, plaque rupture, platelet aggregation, and coagulation system activation. Inflammation plays an important role in the pathogenesis of plaque instability, and results in plaque rupture or erosion.5) Pathological and immunohistochemical staining in the ruptured plaques of patients who have died of AMI have shown a preponderance of inflammatory cell...

show abstract

Administration of a Loading Dose of Atorvastatin Before Percutaneous Coronary Intervention Prevents Inflammation and Reduces Myocardial Injury in STEMI Patients: A Randomized Clinical Study

Cited by 30 publications

References 32 publications

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

Effect of High Dose Rosuvastatin Loading before Primary Percutaneous Coronary Intervention on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction

Plasma Lipoprotein-Associated Phospholipase A2 Level Is an Independent Predictor of High Thrombus Burden in Patients With Acute ST-segment Elevation Myocardial Infarction

Contact Info

Product

Resources

About