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Acute myocardial infarction (AMI) is a critical and contributes to cardiovascular morbidity and mortality.
The aim of the present study was to determine whether the treatment with HMG-CoA reductase inhibitor before the primary intervention could be beneficial in patients with acute myocardial infarction.
We analyzed 201 patients (average: 62 y.o, male: 79%) with acute onset of AMI who received cardiac intervention as a prospective, multicenter, randomized study. Informed consent was obtained from each patient for participation in the study, according to a protocol approved by the Institutional Review Board of Human Research at Saga University. They were divided into 2 groups according to the prescribing of the statin (statin group n=103; nonstatin group n=98). The patients in the statin group received 40 mg dose of atorvastatin before the intervention and then 10mg dose of atorvastatin for 30 days. The primary endpoints were the all-cause death and major adverse cardiac and cerebrovascular events (MACE) on the six months after the onset of AMI. The secondary endpoints were infarct size, left ventricular function, and every kind of biomarkers two weeks after the onset.
There were no significant differences in baseline characteristics between two groups. There were no significant differences in primary end points (38 patients, 38.8% vs. 39 patients, 42.4%, p=0.612) in six months after the onset of AMI. Although there were no significant differences in peak level of creatine kinase, ejection fraction, the plasma levels of IL-6, TNF-X, the levels of PTX3, angiopoietin-like protein2 (ANGPTL2), toxic advanced glycation endproduct (TAGE) were decreased two weeks after the treatment with atorvastatin.
Alhough statin therapy before the primary intervention in patients with AMI did not reduce the risk of primary endpoints in the present study so far, atorvastatin reduced the levels of PTX3, ANGPTL2 and TAGE, and thus, had cardioprotective effects, beyond its lipid lowering effects in patients with AMI.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes: Role of Inflammation
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1258-199
- 2013 American College of Cardiology Foundation