title: Early statin treatment prior to primary PCI for acute myocardial infarction: REPERATOR, a randomized placebo-controlled pilot trial.
abstract: OBJECTIVE
  The aim of this pilot study was to determine whether early atorvastatin treatment will reduce left ventricle (LV) remodeling, infarct size, and improve microvascular perfusion.
  
  
  BACKGROUND
  In animal studies, early statin therapy reduces reperfusion injury after a percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).
  
  
  METHODS
  Forty-two consecutive patients (82% male, mean age 61.2 ± 9.8) who underwent a primary PCI for a first ST-elevated AMI were randomized for pretreatment with atorvastatin 80 mg (n = 20) or placebo (n = 22) and continued with the same dosage daily for 1 week. All patients received atorvastatin 80 mg once daily 7 days after primary PCI. The LV function and infarct size were measured by magnetic resonance imaging within 1 day, at 1 week, and 3 months follow up. The primary endpoint was the end-systolic volume index (ESVI) at 3 months. Secondary endpoints were global LV function measurements, myocardial infarct size, biochemical cardiac markers, TIMI flow, and ST-T elevation resolution.
  
  
  RESULTS
  ESVI 3 months after AMI was 25.1 mL/m(2) in the atorvastatin arm and 25.0 mL/m(2) in the placebo arm (P = 0.74). The differences in change from baseline to 3 months follow up in global LV function and myocardial infarct size did not differ between both treatment arms. Furthermore, biochemical markers, TIMI flow, and ST-T elevation resolution did not differ between atorvastatin and placebo arm.
  
  
  CONCLUSIONS
  In this pilot study, pretreatment with atorvastatin in an acute myocardial infarction does not result in an improved cardiac function, microvascular perfusion, or decreased myocardial infarct size.
authors.affiliation: Department of Cardiology, St. Antonius Hospital Nieuwegein, The Netherlands. s.post@umcutrecht.nl
authors.forename: Simone
authors.initials: S
authors.lastname: Post
authors.forename: Martijn C
authors.initials: MC
authors.lastname: Post
authors.forename: Ben J
authors.initials: BJ
authors.lastname: van den Branden
authors.forename: Frank D
authors.initials: FD
authors.lastname: Eefting
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Goumans
authors.forename: Pieter R
authors.initials: PR
authors.lastname: Stella
authors.forename: Hendrik W
authors.initials: HW
authors.lastname: van Es
authors.forename: Thierry X
authors.initials: TX
authors.lastname: Wildbergh
authors.forename: Benno J
authors.initials: BJ
authors.lastname: Rensing
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003326:Coronary Circulation / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D009426:Netherlands; D054318:No-Reflow Phenomenon / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011758:Pyrroles / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects; D020257:Ventricular Remodeling / Q000187:drug effects
chemical_list: D015415:Biomarkers; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin