title: Effects of First High-Dose Atorvastatin Loading in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention.
abstract: To determine the effects of 80-mg atorvastatin administration for the first time in patients with acute ST segment elevation myocardial infarction (STEMI) before emergency percutaneous coronary intervention (PCI). A total of 118 patients with STEMI who underwent emergency PCI were enrolled in this study. The patients were divided into 80-mg group (n = 59) and 40-mg group (n = 59), according to the loading dose of atorvastatin firstly before operation. The occurrence of no-reflows and changes of HbA1c were observed preoperatively and postoperatively on second and fifth days. All patients were followed up for 1 year with major adverse cardiac events (MACE) recorded. The incidence of no-reflow in 80-mg group was obviously lower than in 40-mg group (13.56% vs. 25.42%) (χ = 4.374, P = 4.374). The preoperative HbA1c levels exhibited no significant difference between 80-mg group and 40-mg group (P > 0.05). The postoperative HbA1c levels in 2 groups showed a trend of gradual decline, which were lower in 80-mg group than in 40-mg group for second day, fifth day, first month, sixth month, and 12th month (all P < 0.05). The postoperative incidence of MACE in 80-mg group was significantly lower than in 40-mg group for sixth and 12th months (both P < 0.05). The incidence of MACE in patients with reflow in 80-mg and 40-mg groups was significantly higher than in patients with no-reflow who were in 80-mg and 40-mg groups for postoperative 12th month (both P < 0.05). The first loading high dose of atorvastatin can significantly prevent occurrence of postoperative no-reflow in patients with STEMI after PCI, reduce HbA1c levels and the incidence of MACE. Clinical randomized controlled trial with larger sample size is required to confirm this finding.
authors.affiliation: Department of Cardiology, Yantaishan Hospital, Yantai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Second Division of Internal Medicine-Cardiovascular Department, the First Hospital of Zibo City, Zibo, China.
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Yantaishan Hospital, Yantai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Yantaishan Hospital, Yantai, China.
authors.forename: Hai-Peng
authors.initials: HP
authors.lastname: Jiang
authors.affiliation: Yantaishan Hospital, Yantai, China.
authors.forename: Wen-Bo
authors.initials: WB
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Wendeng Central Hospital of Weihai, Weihai, China.
authors.forename: Bing-Feng
authors.initials: BF
authors.lastname: Cao
mesh_terms: D000368:Aged; D000069059:Atorvastatin / Q000627:therapeutic use*; D017023:Coronary Angiography; D004305:Dose-Response Relationship, Drug; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D059035:Perioperative Period; D011300:Preoperative Care / Q000379:methods; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000069059:Atorvastatin; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C517652:hemoglobin A1c protein, human