title: Effect of a hydrophilic and a hydrophobic statin on cardiac salvage after ST-elevated acute myocardial infarction - a pilot study.
abstract: OBJECTIVE
  Early statin therapy after acute coronary syndrome reduces atherothrombotic vascular events. This study aimed to compare the effects of hydrophilic and hydrophobic statins on myocardial salvage and left ventricular (LV) function in patients with ST-elevated myocardial infarction (STEMI).
  
  
  METHODS
  Seventy-five STEMI patients who had received emergency reperfusion therapy were enrolled and randomized into the hydrophilic statin group (rosuvastatin; 5 mg/day, n = 38) and hydrophobic statin group (atorvastatin; 10 mg/day, n = 37) for 6 months. LV ejection fraction (LVEF), and B-type natriuretic peptide (BNP) and co-enzyme Q10 (CoQ10) levels were measured at baseline and the end of treatment. The myocardial salvage index was assessed by single photon emission computed tomography with (123-)I-β-methyl-iodophenylpentadecanoic acid (ischemic area-at-risk at onset of STEMI: AAR) and (201-)thallium scintigraphy (area-at-infarction at 6 months: AAI) [myocardial salvage index = (AAR-AAI) × 100/AAR (%)].
  
  
  RESULTS
  Onset-to-balloon time and maximum creatine phosphokinase levels were comparable between the groups. After 6 months, rosuvastatin (-37.6% ± 17.2%) and atorvastatin (-32.4% ± 22.4%) equally reduced low-density lipoprotein-cholesterol (LDL-C) levels (p = 0.28). However, rosuvastatin (+3.1% ± 5.9%, p < 0.05), but not atorvastatin (+1.6% ± 5.7%, p = 0.15), improved LVEF. Rosuvastatin reduced BNP levels compared with atorvastatin (-53.3% ± 48.8% versus -13.8% ± 82.9%, p < 0.05). The myocardial salvage index was significantly higher in the rosuvastatin group than the atorvastatin group (78.6% ± 29.1% versus 52.5% ± 38.0%, p < 0.05). CoQ10/LDL-C levels at 6 months were increased in the rosuvastatin group (+23.5%, p < 0.01) and percent changes in CoQ10/LDL-C were correlated with the myocardial salvage index (r = 0.56, p < 0.01).
  
  
  CONCLUSIONS
  Rosuvastatin shows better beneficial effects on myocardial salvage than atorvastatin in STEMI patients, including long-term cardiac function, associated with increasing CoQ10/LDL-C.
  
  
  BACKGROUND
  URL http://www.umin.ac.jp/ctr/index.htm Unique Identifier: UMIN000003893.
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan; Social Insurance Omuta-Tenryo Hospital, 1-100 Tenryo, Omuta City Fukuoka 836-8566, Japan. Electronic address: titose-t@kumamoto-u.ac.jp.
authors.forename: Tadasuke
authors.initials: T
authors.lastname: Chitose
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan; Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto City 862-0976, Japan. Electronic address: ssugiyam@kumamoto-u.ac.jp.
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan. Electronic address: sakakenn@kumamoto-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakamoto
authors.affiliation: Division of Cardiology, Fukuoka Tokushukai Hospital, 4-5 Sukukita, Kasuga City Fukuoka 816-0864, Japan. Electronic address: hrrmshim@bb.csf.ne.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimomura
authors.affiliation: Social Insurance Omuta-Tenryo Hospital, 1-100 Tenryo, Omuta City Fukuoka 836-8566, Japan. Electronic address: ta-yamashita@omutatenryo-hp.jp.
authors.forename: Takuro
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Kumamoto Red Cross Hospital, 2-1-1 Nagamineminami, Nishi-ku, Kumamoto City 861-8520, Japan. Electronic address: junhokamaki@awa.bbiq.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Hokamaki
authors.affiliation: Kumamoto Red Cross Hospital, 2-1-1 Nagamineminami, Nishi-ku, Kumamoto City 861-8520, Japan. Electronic address: rtsunoda@kumamoto-med.jrc.or.jp.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Tsunoda
authors.affiliation: Department of Medical Diagnostic Radiology, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan. Electronic address: shiraish@kumamoto-u.ac.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.affiliation: Department of Medical Diagnostic Radiology, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan. Electronic address: yama@kumamoto-u.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan. Electronic address: ogawah@kumamoto-u.ac.jp.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000378:metabolism; D004452:Echocardiography; D005227:Fatty Acids / Q000737:chemistry; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006321:Heart / Q000187:drug effects; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007462:Iodobenzenes / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use; D011877:Radionuclide Imaging; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D013793:Thallium / Q000737:chemistry; D015899:Tomography, Emission-Computed, Single-Photon; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D005227:Fatty Acids; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007462:Iodobenzenes; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; C049338:iodofiltic acid; D020097:Natriuretic Peptide, Brain; D014451:Ubiquinone; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D013793:Thallium; C024989:coenzyme Q10
keywords: Reperfusion; ST-elevated acute myocardial infarction; Scintigraphy; Statin