Efficacy of early intensive rosuvastatin therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (ROSEMARY Study).
The purpose of the study was to investigate whether early high-dose potent statin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention can reduce infarct size compared with conventional low-dose statin therapy. In a randomized placebo-controlled multicenter trial, 185 patients were assigned either to an early high-dose rosuvastatin group (n = 92, rosuvastatin 40 mg before treatment plus maintenance for 7 days) or to a conventional low-dose rosuvastatin group (n = 93, placebo before treatment plus rosuvastatin 10-mg maintenance for 7 days). Serial cardiac magnetic resonance imaging (MRI) was performed during the acute (3 to 7 days) and chronic (3 months) phases. The primary end point was relative infarct volume assessed by MRI at 3 months. Baseline characteristics were similar between the 2 groups, except hypertension, which was more prevalent in the high-dose group. Serial MRI data were available for 121 patients (high-dose group n = 54 and low-dose group n = 67). The relative infarct volumes in the acute (23.0 ± 9.5% vs 20.5 ± 11.7%, p = 0.208) and chronic (15.9 ± 8.3% vs 15.8 ± 9.7%, p = 0.943) phases were not different between the groups. No differences between groups were observed for periprocedural microvascular circulation evaluated by Thrombolysis In Myocardial Infarction flow grade, myocardial blush grade, ST-segment resolution, microvascular obstruction on cardiac MRI, or clinical outcomes. In conclusion, early high-dose rosuvastatin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention did not improve periprocedural myocardial perfusion or reduce infarct volume measured by MRI compared with the conventional low-dose rosuvastatin regimen.
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Young-Guk
YG
Ko
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hoyoun
H
Won
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Dong-Ho
DH
Shin
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jung-Sun
JS
Kim
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Byeong-Keuk
BK
Kim
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Donghoon
D
Choi
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Myeong-Ki
MK
Hong
Division of Cardiology, College of Medicine, Konyang University Hospital, Daejeon, Korea.
Jang-Ho
JH
Bae
Division of Cardiology, Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Sahng
S
Lee
Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea.
Do-Sun
DS
Lim
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: Jangys1212@yuhs.ac.
Yangsoo
Y
Jang
D000925:Anticoagulants / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006973:Hypertension / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D010919:Placebos; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage*; D056910:Republic of Korea; D000068718:Rosuvastatin Calcium; D055502:Secondary Prevention; D013449:Sulfonamides / Q000008:administration & dosage*; D016896:Treatment Outcome
D000925:Anticoagulants; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010919:Placebos; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium