Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial

Jung Sun Kim; Jaedeok Kim; Donghoon Choi; Chan Joo Lee; Sang Hak Lee; Young Guk Ko; Myeong Ki Hong; Byoung Keuk Kim; Seong Jin Oh; Dong Woon Jeon; Joo Young Yang; Jung Rae Cho; Nam Ho Lee; Yun Hyeong Cho; Deok Kyu Cho; Yangsoo Jang

doi:10.1016/j.jcin.2009.11.021

Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial

Jung Sun Kim, Jaedeok Kim, Donghoon Choi, Chan Joo Lee, Sang Hak Lee, Young Guk Ko, Myeong Ki Hong, Byoung Keuk Kim, Seong Jin Oh, Dong Woon Jeon, Joo Young Yang, Jung Rae Cho, Nam Ho Lee, Yun Hyeong Cho, Deok Kyu Cho, Yangsoo Jang

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

150 Citations (Scopus)

Abstract

Objectives: This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Background: Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. Methods: A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. Results: MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 ± 12.3 vs. 34.1 ± 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 ± 0.8 vs. 1.9 ± 0.8, p = 0.02 and 61.8 ± 26.2 vs. 50.6 ± 25.8%, p = 0.01). Conclusions: High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717).

Original language	English
Pages (from-to)	332-339
Number of pages	8
Journal	JACC: Cardiovascular Interventions
Volume	3
Issue number	3
DOIs	https://doi.org/10.1016/j.jcin.2009.11.021
Publication status	Published - 2010 Mar

Bibliographical note

Funding Information:
This study was supported in part by a grant from the Korea Health 21 R&D Project, the Ministry of Health and Welfare and Republic of Korea ( 0412-CR02-0704-0001 ), and grants from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs , Republic of Korea (No. A085012 , A000385 , and A085136 ), and Cardiovascular Research Center, Seoul, Korea. The first 2 authors contributed equally to this study.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2009.11.021

Cite this

Kim, J. S., Kim, J., Choi, D., Lee, C. J., Lee, S. H., Ko, Y. G., Hong, M. K., Kim, B. K., Oh, S. J., Jeon, D. W., Yang, J. Y., Cho, J. R., Lee, N. H., Cho, Y. H., Cho, D. K., & Jang, Y. (2010). Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial. JACC: Cardiovascular Interventions, 3(3), 332-339. https://doi.org/10.1016/j.jcin.2009.11.021

@article{b17ef79eb46c43f1b19d0ddf6b858c5c,

title = "Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial",

abstract = "Objectives: This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Background: Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. Methods: A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. Results: MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 ± 12.3 vs. 34.1 ± 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 ± 0.8 vs. 1.9 ± 0.8, p = 0.02 and 61.8 ± 26.2 vs. 50.6 ± 25.8%, p = 0.01). Conclusions: High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717).",

author = "Kim, {Jung Sun} and Jaedeok Kim and Donghoon Choi and Lee, {Chan Joo} and Lee, {Sang Hak} and Ko, {Young Guk} and Hong, {Myeong Ki} and Kim, {Byoung Keuk} and Oh, {Seong Jin} and Jeon, {Dong Woon} and Yang, {Joo Young} and Cho, {Jung Rae} and Lee, {Nam Ho} and Cho, {Yun Hyeong} and Cho, {Deok Kyu} and Yangsoo Jang",

note = "Funding Information: This study was supported in part by a grant from the Korea Health 21 R&D Project, the Ministry of Health and Welfare and Republic of Korea ( 0412-CR02-0704-0001 ), and grants from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs , Republic of Korea (No. A085012 , A000385 , and A085136 ), and Cardiovascular Research Center, Seoul, Korea. The first 2 authors contributed equally to this study. ",

year = "2010",

month = mar,

doi = "10.1016/j.jcin.2009.11.021",

language = "English",

volume = "3",

pages = "332--339",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "3",

}

Kim, JS, Kim, J, Choi, D, Lee, CJ, Lee, SH, Ko, YG, Hong, MK, Kim, BK, Oh, SJ, Jeon, DW, Yang, JY, Cho, JR, Lee, NH, Cho, YH, Cho, DK & Jang, Y 2010, 'Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial', JACC: Cardiovascular Interventions, vol. 3, no. 3, pp. 332-339. https://doi.org/10.1016/j.jcin.2009.11.021

TY - JOUR

T1 - Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial

AU - Kim, Jung Sun

AU - Kim, Jaedeok

AU - Choi, Donghoon

AU - Lee, Chan Joo

AU - Lee, Sang Hak

AU - Ko, Young Guk

AU - Hong, Myeong Ki

AU - Kim, Byoung Keuk

AU - Oh, Seong Jin

AU - Jeon, Dong Woon

AU - Yang, Joo Young

AU - Cho, Jung Rae

AU - Lee, Nam Ho

AU - Cho, Yun Hyeong

AU - Cho, Deok Kyu

AU - Jang, Yangsoo

N1 - Funding Information: This study was supported in part by a grant from the Korea Health 21 R&D Project, the Ministry of Health and Welfare and Republic of Korea ( 0412-CR02-0704-0001 ), and grants from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs , Republic of Korea (No. A085012 , A000385 , and A085136 ), and Cardiovascular Research Center, Seoul, Korea. The first 2 authors contributed equally to this study.

PY - 2010/3

Y1 - 2010/3

N2 - Objectives: This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Background: Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. Methods: A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. Results: MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 ± 12.3 vs. 34.1 ± 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 ± 0.8 vs. 1.9 ± 0.8, p = 0.02 and 61.8 ± 26.2 vs. 50.6 ± 25.8%, p = 0.01). Conclusions: High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717).

AB - Objectives: This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Background: Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. Methods: A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. Results: MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 ± 12.3 vs. 34.1 ± 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 ± 0.8 vs. 1.9 ± 0.8, p = 0.02 and 61.8 ± 26.2 vs. 50.6 ± 25.8%, p = 0.01). Conclusions: High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717).

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Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction. The STATIN STEMI Trial

Abstract

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