Early use of pravastatin in patients with acute myocardial infarction undergoing coronary angioplasty.
OBJECTIVE
To determine whether statin therapy initiated early in acute myocardial infarction together with thrombolytic therapy in patients with acute myocardial infarction results in clinical benefit through early plaque stabilization.


RESULTS
The study population consisted of 77 patients who underwent coronary balloon angioplasty of the infarct-related artery during the first month of acute myocardial infarction. These patients belonged to the cohort of the Pravastatin Turkish Trial (PTT). Forty of them were assigned randomly to have immediate pravastatin (40 mg/day) therapy adjunctive to thrombolytic therapy regardless of serum lipid levels and received statin treatment throughout the study. Lipid levels were determined immediately after admission and before angioplasty and at the end of 6 months. Patients were re-evaluated clinically and angiographically for cardiovascular adverse events and restenosis after a 6-month follow-up period. The baseline angiographic and clinical characteristics of the two groups were similar. The incidence of angina was significantly lower in the pravastatin group (30.0%, 12 patients) compared to the control group (59.5%, 22 patients) (p = 0.018). The cumulative major adverse cardiac events in the pravastatin group were significantly lower when compared to the control group (32.5% vs. 75.6%, p = 0.0001).


CONCLUSIONS
Early initiation of pravastatin therapy immediately after an acute myocardial infarction significantly decreased the frequency of major cardiac adverse events. Such early potential clinical benefits further strengthen the rationale for starting statin treatment as soon as possible after acute coronary events particularly in patients in whom invasive intervention is planned.
Kayikçioğlu
Meral
M
Ege University Medical School, Department of Cardiology, Izmir, Turkey. mekay@med.ege.edu.tr
Can
Levent
L
Kültürsay
Hakan
H
Payzin
Serdar
S
Turkoğlu
Cüneyt
C
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D017035:Pravastatin / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D005343:Fibrinolytic Agents; D017035:Pravastatin