title: Impact of long-term statin pretreatment on myocardial damage in ST elevation myocardial infarction (from the AIDA STEMI CMR Substudy).
abstract: Nonrandomized studies suggested lower mortality rates with statin pretreatment in patients with acute ST elevation myocardial infarction (STEMI). However, clinical data are still inconclusive and the mechanisms of these presumed beneficial effects require further exploration. Cardiac magnetic resonance (CMR) imaging offers the possibility of studying a variety of markers of myocardial damage and reperfusion injury after myocardial infarction. The aim of this study was to assess a possible link of statin pretreatment with myocardial damage in acute STEMI. The multicenter Abciximab i.v. versus i.c. in ST-elevation Myocardial Infarction CMR substudy enrolled 795 consecutive patients with acute STEMI who underwent primary angioplasty within 12 hours of symptom onset. CMR studies assessing left ventricular ejection fraction, infarct size, microvascular obstruction, area at risk, and myocardial salvage index were performed in a median of 3 days after the clinical event. We performed a retrospective analysis to evaluate the impact of statin pretreatment on myocardial damage. Information on statin pretreatment was available in 791 of 795 patients (99%). Of these, 122 (15%) had long-term statin pretreatment. CMR results showed no significant differences in the area at risk, left ventricular ejection fraction, infarct size, microvascular obstruction, and myocardial salvage index between patients with and without statin pretreatment. Furthermore, no differences in short- and long-term outcomes could be observed. In conclusion, in this CMR study, statin pretreatment in patients with STEMI was not associated with lesser myocardial damage.
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. Electronic address: georg.fuernau@medizin.uni-leipzig.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Fuernau
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.affiliation: Department of Internal Medicine II-Cardiology, University of Ulm, Ulm, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
authors.affiliation: Department of Cardiology, Herz- und Gefäß-Klinik Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kerber
authors.affiliation: Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Bernward
authors.initials: B
authors.lastname: Lauer
authors.affiliation: Medizinische Klinik/Kardiologie, Klinikum Nürnberg, Nürnberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Pauschinger
authors.affiliation: Medizinische Klinik/Kardiologie, Klinikum Nürnberg, Nürnberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schwab
authors.affiliation: Department of Cardiology, University of Rostock, Rostock, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Birkemeyer
authors.affiliation: Medical Clinic I, Klinikum Pforzheim, Pforzheim, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pfeiffer
authors.affiliation: Clinical Trial Center Leipzig, University Leipzig, Leipzig, Germany.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Mende
authors.affiliation: Clinical Trial Center Leipzig, University Leipzig, Leipzig, Germany.
authors.forename: Oana
authors.initials: O
authors.lastname: Brosteanu
authors.affiliation: Clinical Trial Center Leipzig, University Leipzig, Leipzig, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Neuhaus
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany; Medical Clinic II, University of Lübeck, Lübeck, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany; Department of Cardiology, Heart Center, Segeberger Kliniken, Bad Segeberg, Germany.
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gutberlet
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany; Medical Clinic II, University of Lübeck, Lübeck, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors