Reduction of No Reflow with a Loading Dose of Atorvastatin before Primary Angioplasty in Patients with Acute ST Myocardial Infarction

García-Méndez, Rosalba Carolina; Almeida-Gutiérrez, Eduardo; Serrano-Cuevas, Leonor; Sánchez-Díaz, Jesús Salvador; Rosas‐Peralta, Martín; Ortega-Ramírez, José Alberto; Palomo-Villada, Jose Antonio; Isordia‐Salas, Irma; Alonso-Bravo, Rosa Marisol; Borrayo–Sánchez, Gabriela

doi:10.1016/j.arcmed.2018.10.006

Cited by 20 publications

(12 citation statements)

References 29 publications

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“…Garcia et al [ 43 ] demonstrated that an extensive dose of atorvastatin administration prior to primary PCI may improve microvascular coronary perfusion assessed by combined no-reflow parameters (ST < 50%, no-reflow angiographically and no-reflow by SPECT). In the study, 103 STEMI patients within 12 h duration of symptoms received either 80 mg atorvastatin additional to standard treatment (AST) before undergoing primary PCI or standard treatment alone (ST).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Treatment Efficacy of Rosuvastatin versus Atorvastatin Loading Prior to Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction

Adel

Elberry

Aziz

et al. 2022

JCM

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The aim of this study was to compare the effect of a single high-dose rosuvastatin versus atorvastatin preloading in ST-elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PCI.) Methods: A total of 99 patients presented with STEMI and were randomly divided into three groups—a control group (n = 33) with no statin treatment, an atorvastatin group (n = 33) with a single 80 mg atorvastatin dose and the rosuvastatin group (n = 33) with a single 40 mg rosuvastatin dose in the emergency room (ER) prior to PCI. Post-interventional thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) were recorded, and ST-segment resolution was measured. Results: CTFC was significantly lower for the atorvastatin group (p-value < 0.01) than in the control group. A final TIMI flow grade 3 was achieved in 32 (97.0%) patients in the rosuvastatin group and 28 (84.8%) patients in the atorvastatin group compared with only 25 (75.8%) patients in the control group (p = 0.014). Peak CK-MB in the rosuvastatin group (263.2 [207.2–315.6]) and the atorvastatin group (208 [151.0–314.1]) was lower compared to that in the control group (398.4 [303.9–459.3]); p < 0.001. Conclusions: A single extensive dose of lipophilic atorvastatin prior to primary PCI in STEMI patients showed better improvement in microvascular myocardial perfusion compared to hydrophilic rosuvastatin.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Treatment Efficacy of Rosuvastatin versus Atorvastatin Loading Prior to Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction

Adel

Elberry

Aziz

et al. 2022

JCM

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“…Previously, dual antiplatelet and antithrombotic interventions mainly focused on perioperative PCI. However, clinical studies indicate that atorvastatin administration before and after an emergency or elective PCI helped reduce the risk of perioperative and postoperative MACE for patients with myocardial infarction [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Enhanced-Dose Statins for ST-Segment Elevation Myocardial Infarction Patients after Emergency Percutaneous Coronary Intervention

et al. 2022

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Background. Acute ST-segment elevation myocardial infarction (STEMI) is a serious multiple acute cardiovascular disease. This study investigated the effect of statins on the efficacy and prognosis of STEMI patients after emergency PCI. Methods. From October 2019 to January 2021, 98 patients with STEMI in our hospital were selected and divided into study group and control group. The study group took atorvastatin 40 mg 2 hours before surgery, 40 mg/day after surgery, and 20 mg/day 1 week later. The control group received 20 mg of atorvastatin every night after admission. The cardiac output, left ventricular ejection fraction, blood flow classification, vagus nerve function, heart rate deceleration force and chemoreflex sensitivity were compared between the two groups, and recorded the incidence of adverse reactions before and after treatment and 3 months after treatment. The number of major adverse cardiac events (MACEs) was also recorded. Results. Before treatment, there were no differences in CO, CI, and LVEF between the study and control groups. After treatment, CO, CI, and LVEF in the study group were significantly higher than those in the control group. Before treatment, there was no significant difference in TIMI blood flow classification among the groups, and after treatment, the study group was better than the control group. DC and ChRS were significantly higher in the study group than in the control group. There was no difference in the incidence of adverse reactions between the study group and the control group. However, the incidence of MACE in the study group was lower than that in the control group. Conclusion. Enhanced-dose atorvastatin for STEMI patients improved PCI treatment effect, cardiac function, and vagus nerve function and reduced the incidence of adverse cardiac events. Thus, statins are safe and worth considering.

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“…49 A study showed that the administration of 80 mg of atorvastatin before PCI reduced the incidence of noreflow and MACE, and increased survival. 50…”

Section: Statins and Reperfusionmentioning

confidence: 99%

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Rangel¹

2021

International Journal of Cardiovascular Sciences

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ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies -intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), antiinflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre-and post-conditioning and stem cell therapy -have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results: These therapies need confirmation in larger studies to be implemented in clinical practice PrevalenceThe worldwide prevalence of ischemic heart disease is approximately 111 million cases, with 7.3 million cases of fatal acute myocardial infarction (AMI) in 2015. The inadequate treatment of patients with AMI is associated with significant increases in morbidity and mortality. 1 ObjectivesThe objective of this systematic review is to evaluate the evidence of different reperfusion therapies in STsegment elevation AMI (STEMI), selecting mainly randomized controlled trials and systematic reviews that address major cardiovascular clinical outcomes. MethodsThe review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched the PubMed database for the terms "acute myocardial infarction" and "reperfusion therapy", which yielded 9,885 results. After applying the following search filters -type of abstract: "text and full text"; type of article: "metaanalysis, review, systematic review and randomized clinical trial", and date of publication: "last 5 years", and language: "English" -127 articles were obtained. In addition, research was conducted at the Cochrane Central Register of Controlled Trials using the terms "acute myocardial infarction" and "reperfusion therapy", in English, between 2018 and 2020, which revealed 64 clinical trials, already excluding duplicates. Of the 191

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Reduction of No Reflow with a Loading Dose of Atorvastatin before Primary Angioplasty in Patients with Acute ST Myocardial Infarction

Cited by 20 publications

References 29 publications

Comparison of the Treatment Efficacy of Rosuvastatin versus Atorvastatin Loading Prior to Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction

Comparison of the Treatment Efficacy of Rosuvastatin versus Atorvastatin Loading Prior to Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction

Enhanced-Dose Statins for ST-Segment Elevation Myocardial Infarction Patients after Emergency Percutaneous Coronary Intervention

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

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