title: Myocardial Infarct Size in Patients on Long-Term Statin Therapy Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction.
abstract: Statin pretreatment has been reported to have a cardioprotective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI are still controversial. We prospectively evaluated the effect of long-term statin therapy on infarct size (IS), myocardial salvage index (MSI), and microvascular obstruction (MVO) in consecutive patients with STEMI who underwent primary PCI. Two-hundred thirty patients with STEMI (mean age 61 ± 11 years, 183 men) who underwent primary PCI were evaluated with cardiac magnetic resonance (CMR) imaging during hospitalization (median 4 days after primary PCI). In all patients, we measured peak troponin I level, whereas IS, MSI, and MVO were determined by CMR. Fifty patients (22%) were on long-term statin therapy and showed a significantly lower troponin I peak value compared to patients without previous statins (54 ± 47 vs 88 ± 106 ng/ml; p = 0.02). At CMR evaluation, IS related to the index event was significantly smaller (12.5 ± 11.5 vs 18.5 ± 18.5 g, p = 0.05), and MSI was higher (0.68 ± 0.25 vs 0.52 ± 0.30; p <0.01) in patients with previous statin therapy. MVO was also less frequent (10% vs 20%; p = 0.14) in this group. At multivariate analysis, previous statin therapy remained significantly associated with IS and MSI (p = 0.05 and 0.02, respectively). In conclusion, this study suggests that long-term statin therapy before primary PCI in patients with STEMI is associated with smaller IS and higher MSI. Future studies are warranted to confirm these findings and to investigate potential clinical implications.
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: giancarlo.marenzi@ccfm.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Marenzi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cosentino
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cortinovis
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Milazzo
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Rubino
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cabiati
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: De Metrio
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Moltrasio
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Lauri
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Jeness
authors.initials: J
authors.lastname: Campodonico
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Bonomi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Veglia
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCSS), Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bartorelli
mesh_terms: D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; 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* / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors