title: Effect of statin pretreatment on the outcome of ST-segment elevation myocardial infarction in patients without prior history of coronary artery disease.
abstract: BACKGROUND
  Early statin treatment has beneficial effects on the prognosis after acute coronary syndromes. We investigated the impact of prior statin treatment on the outcome of patients without a prior history of coronary artery disease (CAD) who presented with ST-elevation myocardial infarction (STEMI) and were treated with thrombolysis.
  
  
  METHODS
  The study enrolled 1032 consecutive patients who satisfied the above criteria. They were categorized into two groups, based on their prior statin treatment for at least 3 months before admission: the statin pretreatment group (n=124) and the statin-naïve group (n=908). All patients received high-dose statins during hospitalization and were prescribed statins after discharge. The primary outcome was the incidence of successful thrombolysis, as expressed by the percentage of patients with 50% ST-segment resolution and complete retrosternal pain resolution at 90 minutes. Secondary outcomes included reduction in high-sensitivity C-reactive protein (hs-CRP) and CK-MB levels, and in-hospital, short- and long-term cardiovascular mortality.
  
  
  RESULTS
  ST-segment resolution 50% was observed in 63.7% of the statin-pretreatment group and in 49.1% of statin-naïve patients (p<0.01). Statin pretreatment was associated with lower hs-CRP and peak CK-MB levels (p<0.001). The statin-pretreatment group had lower 30-day mortality (5.6% vs. 12.3%, p<0.05), whereas no significant differences were detected in in-hospital or 3-year mortality.
  
  
  CONCLUSIONS
  Prior statin treatment in patients without a history of CAD who present with STEMI is associated with successful thrombolysis, decreased systemic inflammation, a lesser degree of myocardial damage, and a possible reduction in short-term mortality.
authors.affiliation: Cardiology Department, Sismanoglion Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mytas
authors.forename: Michael
authors.initials: M
authors.lastname: Zairis
authors.forename: Antonios
authors.initials: A
authors.lastname: Karanasos
authors.forename: Lamprini
authors.initials: L
authors.lastname: Kosma
authors.forename: Petros
authors.initials: P
authors.lastname: Arsenos
authors.forename: Costas
authors.initials: C
authors.lastname: Tentolouris
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Stefanos
authors.initials: S
authors.lastname: Foussas
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Dennis
authors.initials: D
authors.lastname: Cokkinos
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D010351:Patient Discharge; D011446:Prospective Studies; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form