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Myocardial necrosis triggers complement activation and neutrophyl adhesion which is mediated by Intercellular Adhesion Molecule (ICAM). Results from ARMYDTCTAP A-CAMS, showed that Atorvastatin continuous treatment reduced ICAM value in patients with stable angina pectoris. To date, there is no study yet which investigates the effect of acute Atorvastatin 80mg treatment in patients with ST Segment Elevation Myocardial Infarction (STEMI) post Primary Percutaneous Coronary Intervention (PPCI).
This is a randomized, double-blinded, controlled trial. Evaluations were performed on 76 STEMI patients who underwent PPCI at National Cardiac Center Harapan Kita (NCCHK) from February 2014 to August 2014. Patients were randomly classified into two groups (Atorvastatin 80 mg and Placebo).Laboratory data on ICAM were taken twice (0-hour and 24-hour post PPCI) and examined at Prodia’s Laboratorium. Statistical analyses using SPSS were performed to evaluate the effect of Atorvastatin treatment, which was measured by delta ICAM.
There were no difference between two groups (Atorvastatin vs. Placebo) in terms of clinical, supporting data, and angiographic findings. Delta ICAM values showed significant difference between two groups, which are Atorvastatin 80 mg (-13.0±38.5 ng/mL) and Placebo (26.1±67.0 ng/mL, p 0.003). Linear regression analysis (adjusted analysis; according to age, sex, diabetes, and renal insufficiency) showed coefficient of -31.17 ng/mL with p 0.037.
This study showed that acute Atorvastatin 80 mg treatment pre-PPCI reduces endothelial inflammatory response which was measured by ICAM.
Keywords: STEMI, PPCI, inflammation, Atorvastatin, ICAM