Effect of high dose statin preloading on TIMI flow in patients presenting with ST-Elevation Myocardial Infarction undergoing Primary Percutaneous Coronary Intervention

Abstract

The value of high intensity statins loading in acute STEMI patients undergoing primary PCI is still a debatable subject. The benefits of statin pre-treatment before PCI have been supported with previous studies for patients with stable angina pectoris and ACS (unstable angina and non-STEMI); however, only a few retrospective studies have evaluated statin pre-treatment in STEMI. The aim of our study was to assess the impact of high intensity statins used prior to primary PCI in patients presenting with acute STEMI on myocardial perfusion and in-hospital MACE. Results for age, gender, hypertension, smoking, history of ischemic heart disease and Diabetes did not show any statistical significance of value between the cases and control groups. However, there was a statistically significant improvement in TIMI flow and MBG in the cases group compared to the control group (P value 0.010). In the control group there were 4 patients with TIMI I flow and MBG I, 13 with TIMI II flow and MBG II and 68 with TIMI III flow and MBG III. Meanwhile in the cases group there was 1 patient with TIMI I flow and MBG I, 3 with TIMI II flow and MBG II and 81 with TIMI III flow and MBG III. There was also a statistically significant improvement when comparing the 2 groups regarding complete ST-segment resolution and ejection fraction (EF). There were 34 patients in the cases group who showed complete ST-segment resolution (40%) vs 19 patients (22.4%) in the control group which was statistically significant with a P value of 0.013. In addition, EF measured by M-mode had values of Mean+-SD of 45.91 ± 5.49 in cases group vs 43.01 ± 8.80 in control group which was statistically significant with a P value of 0.011. Our study also showed no statistical significance between the two groups regarding in-hospital MACE after primary PCI.