Effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction

Abstract

Objective Evidence of therapy for dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) is limited. This study was performed to compare the effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation. Methods This retrospective study enrolled 597 consecutive patients with STEMI who underwent pPCI in 3 centers from June 2016 to December 2019. Dysfunctional coronary circulation was defined by the thrombolysis in myocardial infarction (TIMI) grade and the TIMI myocardial perfusion grade (TMPG). Logistic regression analysis was used to evaluate the impact of different statin types on dysfunctional coronary circulation. Results The incidence of TIMI no/slow reflow did not differ between the two groups, but the incidence of TMPG no/slow reflow was significantly lower in the atorvastatin than rosuvastatin group (44.58% vs. 57.69%, respectively). After multivariate adjustment, the odds ratio with 95% confidence interval of rosuvastatin was 1.72 (1.17–2.52) for after pretreatment TMPG no/slow reflow and 1.73 (1.16–2.58) for after stenting TMPG no/slow reflow. Atorvastatin and rosuvastatin showed no significant differences in clinical outcomes during hospitalization. Conclusions Compared with rosuvastatin, atorvastatin was associated with better coronary microcirculatory perfusion in patients with STEMI who underwent pPCI.

Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention

“…In addition, our data suggested that statin use was lower in the NR group than in the reflow group, and statins may reduce the incidence of NR. This result is consistent with the conclusion of Zhou et al [ 29 ]. Although the mechanism for this is not fully understood, it may result from improved endothelial function, inhibition of thrombogenic function, improved stability of atherosclerotic plaques, and reduced oxidative stress and vascular inflammation [ 30 ].…”

Predictors of Contrast Induced Nephropathy in Patients with STEMI

“…Statins are the cornerstone of the lipid-lowering treatment and recommended to be administered during the course of STEMI in order to reduce major adverse cardiovascular event rates. 5 Statins have pleiotropic effects and may reduce CIN risk by antioxidant and anti-inflammatory actions. 6 In the present study, 1 the use of statins was not evaluated; it would be better if this was added into the regression analysis.…”