Abstract 11912: Beneficial Myocardial Effects of Immediate Rosuvastatin-Therapy on Left Ventricular Functions after ST-Elevated Myocardial Infarction
Background Immediate statin-therapy after acute coronary syndromes has been established to reduce atherothrombotic vascular events, however effects of the immediate statin-therapy, hydrophilic or lipophilic statins, on left ventricular (LV) functions after ST-elevated myocardial infarction (STEMI) with damaged and dying myocardium is unknown.
Methods From 2008 to 2010, 91 STEMI patients, emergently admitted to four medical centers were enrolled. Finally, 81 STEMI patients without cardiogenic shock who had received successful reperfusion therapy with direct coronary stenting were randomized into 2 groups: hydrophilic statin-group (rosuvastatin; 5mg/day, n=42) and lipophilic statin-group (atorvastatin; 10mg/day, n=39) and followed-up for 24 weeks. LV ejection fraction (LVEF) was assessed by echocardiography. Myocardial salvage index (MSI) was calculated by imaging analysis with 123-BMIPP (ischemic myocardial area at risk at STEMI onset: AAR) and 201-Thallium scintigraphy (myocardial area at infarction at 6 months: AAI) with single photon emission computed tomography [MSI=(AAR-AAI)*100/AAR%]. B-type natriuretic peptide (BNP) levels were measured at baseline and follow-up.
Results On STEMI admission, onset-to-balloon time (OBT) and peak creatinin phosphokinase (p-CPK) levels were comparable between rosuvastatin and atorvastatin (OBT; 4.1±3.4 vs. 4.1±2.9 hr, p=0.97, p-CPK; 3079±2056 vs. 2515±2396 IU/L, p=0.28). After 24 weeks, rosuvastatin and atorvastatin significantly and equally decreased low-density lipoprotein cholesterol levels (−37.6±17.2 vs. −32.4±22.4%, p=0.28). However, rosuvastatin, but not atorvastatin, significantly improved LVEF (rosuvastatin; +3.1±5.9%, p<0.05, atorvastatin; +1.6±5.7%, p=0.15). Furthermore, rosuvastatin significantly reduced BNP levels compared to atorvastatin (rosuvastatin: −53.3±48.8 vs. atorvastatin: −13.8±82.9%, p<0.05). MSI was significantly greater in rosuvastatin than atorvastatin (MSP: 78.6±29.1 vs. 52.5±38.0%, p<0.05).
Conclusions Rosuvastatin compared to atorvastatin, provides significant benefits on myocardial salvage in STEMI patients, potentially exhibiting advantageous effects on chronic phase cardiac function after acute myocardial damage.
- © 2011 by American Heart Association, Inc.