Vol 76, No 3 (2018)
Original articles
Published online: 2017-12-08

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Chronic statin treatment is a predictor of pre-interventional infarct-related artery patency in patients with ST elevation myocardial infarction treated with percutaneous coronary intervention

Süleyman Özbiçer, Mustafa Gür, Gülhan Kalkan, Betül Özaltun, Murat Çaylı
Kardiol Pol 2018;76(3):542-547.

Abstract

 Background: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct-related artery (IRA) patency before percutaneous coronary intervention (PCI) is known to be a strong pre­dictor of improved clinical outcome.

Aim: We aimed to investigate the effects of chronic statin treatment before admission on IRA patency after myocardial infarction.

Methods: In this study, 938 ST elevation myocardial infarction (STEMI) patients admitted to the hospital within the first 12 h of symptom onset were prospectively enrolled (male, n = 682; female, n = 256; mean age 58.6 ± 12.4 years). All patients underwent emergent primary PCI. Patients were divided into two groups based upon angiographic IRA patency. Impaired IRA patency was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 0 and 1 flow (non-patent IRA group). Angiographic IRA patency was defined as TIMI 2 and 3 flow (patent IRA group).

Results: Previous statin usage was more frequent in the patent IRA group (n = 138; 71.9%), than in the non-patent IRA group (n = 110; 14.7%; p < 0.001). Pre-PCI IRA patency was independently associated with body mass index (odds ra­tio [OR] = 1.087, 95% confidence interval [CI] 1.005–1.176, p < 0.001), previous chronic statin use (OR 0.065, 95% CI 0.043–0.098, p = 0.039), ejection fraction (OR 1.041, 95% CI 1.018–1.064, p < 0.001), and SYNTAX score (OR 0.927, 95% CI 0.899–0.957, p < 0.001) in multivariate logistic regression analysis.

Conclusions: Chronic pre-treatment with statins is a significant predictor of the IRA patency in patients with STEMI.

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Polish Heart Journal (Kardiologia Polska)