Study Of Effects Of Statin On Inflammatory Reaction And Cardiac Remodeling In Patients Diagnosed With Acute Myocardial Infarction Underwent Primary Percutaneous Coronary Intervention

Background:Stains have pleiotropic effects independent of cholesterol lowering. They may attenuate coronary micro-embolization in patients underwent percutaneous coronary intervention (PCI) by anti-inflammatory effect. The purpose of this study is to find out whether a single high-dose rosuvastatin loading prior to PCI in patients diagnosed with ST-segment elevation acute myocardial infarction (STEMI) has beneficial influence on inflammatory reaction and cardiac remodeling.Methods:49 patients diagnosed with STEMI, whose infarction-related arteries were all anterior descending branches, were assigned to either the group of no statin treatment before PCI (control group:n=39,61±12 years old,82% male) or the group of 40 mg rosuvastatin loading before PCI (statin group:n=10,59±13 years old,90% male). After PCI, both groups were treated with 10mg rosuvastatin daily. The primary end point was 30-day incidence of major adverse cardiovascular events (MACE), including cardiac death, nonfatal myocardial infarction and target vessel revascularization. The Secondary end point was 12-month incidence of MACE. Creatinine kinase-MB (CK-MB), cardiac troponin T (cTnT), monocyte chemotactic protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and osteopontin were measured before PCI and at 12h, 36h and 60h after PCI. All patients took echocardiogram measurements in 7-day and 12-month after PCI.Results:There were no significant differences in clinical characteristics between the 2 groups. MACEs occurred in 2 (5.1%) patients in control group while no incidence of MACE in statin group. CK-MB and cTnT levels were not different at any time point in the 2 arms. MCP-1, MMP-9, TIMP-1 and osteopontin levels were not different before PCI in the either group. MCP-1 levels were significantly lower in statin versus control group at 36h (5.87±14.47 vs.86.25±23.02 pg/ml, p<0.001) and at 60h (62.34±13.11 vs,85.33±23.21pg/ml, p=0.01) after PCI. The ratio of MMP-9/TIMP-1 levels were also lower in statin versus control group at 60h after PCI (35.1519.14 vs.45.6719.76, p=0.009). Osteopontin levels were not different at any time point in the 2 arms. There were no significant differences in left ventricular ejection fraction, left ventricular end diastolic and systolic volume between the 2 groups.Conclusion:A single high-dose of rosuvastatin intensive treatment on STEM I patients prior to primary PCI did not show a significant reduction of MACEs but it inhibited inflammatory reaction and to some extent, attenuated cardiac remodeling after PCI.