Relation Between Previous Lipid-Lowering Therapy and Infarct Size (Creatine Kinase-MB Level) in Patients Presenting With Acute Myocardial Infarction

Aronow, Herbert D.; Lincoff, A. Michael; Quinn, Martin; McRae, Amy; Gurm, Hitinder S.; Houghtaling, Penny L.; Granger, Christopher B.; Harrington, Robert A.; Werf, F. Van de; Topol, Eric J.; Lauer, Michael S.

doi:10.1016/j.amjcard.2008.06.032

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…The dose of atorvastatin used in this study is considered safe [14] and is similar to previously used doses shown to have cardioprotective effects in terms of limiting infarct size in rats [15],[16]. As statin use has been reported to have cardioprotective effects in patients when initiated prior to the onset of MI [17] and in the first few weeks after MI [18], we chose to treat the animals before and after the onset of MI to mimic the common clinical situation in which patients are treated with statins chronically, i.e., during the entire peri-infarct period. Three weeks into the treatment, rats were anesthetized with ketamine (37 mg/kg) and xylazine (5 mg/kg), intubated, and ventilated with a rodent respirator (Harvard Apparatus).…”

Section: Methodsmentioning

confidence: 80%

Atorvastatin Therapy during the Peri-Infarct Period Attenuates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

et al. 2011

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Although statins impart a number of cardiovascular benefits, whether statin therapy during the peri-infarct period improves subsequent myocardial structure and function remains unclear. Thus, we evaluated the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis after myocardial infarction (MI). Two groups of rats were subjected to permanent coronary occlusion. Group II (n = 14) received oral atorvastatin (10 mg/kg/d) daily for 3 wk before and 4 wk after MI, while group I (n = 12) received equivalent doses of vehicle. Infarct size (Masson's trichrome-stained sections) was similar in both groups. Compared with group I, echocardiographic left ventricular ejection fraction (LVEF) and fractional area change (FAC) were higher while LV end-diastolic volume (LVEDV) and LV end-systolic and end-diastolic diameters (LVESD and LVEDD) were lower in treated rats. Hemodynamically, atorvastatin-treated rats exhibited significantly higher dP/dtmax, end-systolic elastance (Ees), and preload recruitable stroke work (PRSW) and lower LV end-diastolic pressure (LVEDP). Morphometrically, infarct wall thickness was greater in treated rats. The improvement of LV function by atorvastatin was associated with a decrease in hydroxyproline content and in the number of apoptotic cardiomyocyte nuclei. We conclude that atorvastatin therapy during the peri-infarct period significantly improves LV function and limits adverse LV remodeling following MI independent of a reduction in infarct size. These salubrious effects may be due in part to a decrease in myocardial fibrosis and apoptosis.

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Section: Methodsmentioning

confidence: 80%

Atorvastatin Therapy during the Peri-Infarct Period Attenuates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

et al. 2011

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“…One study showed the correlation between statin pretreatment and reduced myocardial necrosis at high-risk patients undergoing PCI. 23 Likewise, in a large cohort study, it was found that statin therapy before PCI was associated with a significant mortality reduction after 30 days (early follow-up) and 6 months after the intervention (intermediate follow-up). 24 The significant effect of pre-treatment with fluvastatin on reducing MACE was also reported in patients with average cholesterol levels undergoing their first successful PCI.…”

Section: Resultsmentioning

confidence: 97%

Impact of Omega-3 Supplementation on High Sensitive C-Reactive Protein Level and 30-Day Major Adverse Cardiac Events After the Implementation of Coronary Stent in Patients with Chronic Kidney Disease: A Randomized Clinical Study

Foroughinia¹,

Nouri²,

Kojuri³

et al. 2018

Adv Pharm Bull

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Purpose: Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adverse effects of percutaneous coronary intervention (PCI). In addition, the role of elevated high sensitive C-reactive protein (hs-CRP) in the prediction of adverse cardiac outcomes after coronary stent implantation has already been shown. Therefore, in this study, we aimed to evaluate the effect of omega-3 supplementation on hs-CRP and 30-day major adverse cardiac events (MACE) in patients with CKD undergoing elective PCI.Methods: In this randomized trial, 80 CKD patients who were candidates for elective PCI, were randomly assigned to two groups; the first group received a single dose of omega-3 (2500 mg, 12 h before PCI) as well as the standard drug regimen of PCI and the second group received placebo plus the standard therapy (325 mg loading dose of aspirin, 600 mg loading dose of clopidogrel, and weight-adjusted intravenous heparin). Hs-CRP levels were measured at baseline and 24 h after the intervention as a primary endpoint. The secondary endpoint was the incidence of MACE over a 30-day period after PCI.Results: Omega-3 did not significantly decrease post-PCI serum level of hs-CRP; however, the overall 30-day MACE was significantly lower in the omega-3 group compared to the control group (p=0.05).Conclusion: Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; hence, omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI. The evaluation of the effect of omega-3 on long-term MACE is recommended for future studies.

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“…3 In addition, lipid-lowering therapy before MI is associated with reduced myocardial necrosis as evaluated by peak creatine kinase-MB activity. 4 However, the cardioprotective effects of statins, the most widely used hypolipidemic drugs, may be indirect via its effects on endothelial function and on myocardial perfusion post-MI. 5 In addition, these cardioprotective effects of statins are at least partly independent of cholesterol lowering.…”

Section: Introductionmentioning

confidence: 99%

Low-density lipoprotein receptor gene transfer in hypercholesterolemic mice improves cardiac function after myocardial infarction

et al. 2011

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Left ventricular (LV) function post-myocardial infarction (MI) is adversely influenced by hypercholesterolemia independent of the severity of coronary atherosclerosis. The objective of this study was to evaluate whether lipid lowering by adenoviral low-density lipoprotein (LDL) receptor (AdLDLr) gene transfer in C57BL/6 LDL receptor (LDLr)-deficient mice beneficially affects ventricular remodeling and cardiac function post-MI independent of effects on the coronary circulation. AdLDLr transfer reduced plasma cholesterol by 77% (P<0.0001). Survival 28 days post-MI was higher in AdLDLr-treated mice (95%) compared with control mice (80%) (P<0.05) (hazard ratio for mortality 0.26, 95% confidence interval 0.11–0.84). Infarct size was not significantly different at day 1 and day 7 but was reduced by 18% (P<0.05) at day 28 in AdLDLr MI mice compared with control MI mice. Cardiomyocyte hypertrophy and interstitial fibrosis were reduced and neovascularization was increased in AdLDLr MI mice. LDLr gene transfer had beneficial effects on endothelial progenitor cell (EPC) number and ex vivo EPC function. LV contractility and relaxation were better preserved in AdLDLr MI mice compared with control MI mice. In conclusion, lipid lowering in hypercholesterolemic mice exerts direct cardioprotective effects resulting in enhanced survival, reduced infarct size, decreased ventricular remodeling and better cardiac function.

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Relation Between Previous Lipid-Lowering Therapy and Infarct Size (Creatine Kinase-MB Level) in Patients Presenting With Acute Myocardial Infarction

Cited by 6 publications

References 29 publications

Atorvastatin Therapy during the Peri-Infarct Period Attenuates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

Atorvastatin Therapy during the Peri-Infarct Period Attenuates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

Impact of Omega-3 Supplementation on High Sensitive C-Reactive Protein Level and 30-Day Major Adverse Cardiac Events After the Implementation of Coronary Stent in Patients with Chronic Kidney Disease: A Randomized Clinical Study

Low-density lipoprotein receptor gene transfer in hypercholesterolemic mice improves cardiac function after myocardial infarction

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