Abstract 15198: Infarct Size in Patients on Chronic Statin Therapy Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Introduction: Statin pre-treatment has been reported to have a cardio-protective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI are still controversial.
Hypothesis: We prospectively evaluated the effect of chronic statin therapy on infarct size (IS), myocardial salvage index (MSI), and micro-vascular obstruction in consecutive STEMI patients undergoing primary PCI.
Methods: Two-hundred-thirty STEMI patients (mean age 61±11 years, 183 men) who underwent primary PCI were evaluated with cardiac magnetic resonance (CMR) imaging during hospitalization (median 4 days after primary PCI). In all patients, we measured peak troponin I level, while IS, MSI, and micro-vascular obstruction were determined by CMR.
Results: Fifty (22%) patients were on chronic statin therapy and showed a significantly lower troponin I peak value when compared to patients without prior statins (54±47 vs. 88±106 ng/ml; P=0.02). At CMR evaluation, IS related to the index event was significantly smaller (12.5±11.5 vs. 18.5±18.5 grams,P=0.05), and MSI was higher (0.68±0.25 vs. 0.52±0.30; P=0.01) in patients with prior statin therapy. Micro-vascular obstruction was also less frequent (10% vs. 20%; P=0.14) in this group. At multivariable analysis, prior statin therapy remained significantly associated with IS and MSI (P=0.05 and P=0.02, respectively). No significant association was observed between index IS and LDL-cholesterol levels at hospital admission in the entire population (P=0.91). Moreover, no relationship between IS or MSI and statin dose (r=-0.10, P=0.56 and r=0.10, P=0.55, respectively), and length of statin treatment (r=-0.06, P=0.71 and r=0.29; P=0.10, respectively) was found.
Conclusions: The results of the present study demonstrated that prior statin therapy is associated with significant smaller IS and higher MSI in patients presenting with STEMI and treated with primary PCI. Whether these preliminary findings will translate into a potential therapeutic strategy warrants further research.
Author Disclosures: N. Cosentino: Research Grant; Significant; Nicola Cosentino was supported by a Fondazione Umberto Veronesi Fellowship, Nicola Cosentino was supported by a Fondazione Umberto Veronesi Fellowship. S. Cortinovis: None. V. Milazzo: None. M. Rubino: None. A. Cabiati: None. M. De Metrio: None. M. Moltrasio: None. G. Lauri: None. G. Pontone: None. G. Marenzi: None.
- © 2015 by American Heart Association, Inc.