The effect of loading dose of rosuvastatin on peri-procedural myocardial infarction

Abstract

Background and Aim: High-dose statin therapy before percutaneous coronary intervention (PCI) is thought to reduce the occurrence of peri-procedural myocardial infarction (PPMI), which is known to be associated with increased mortality and prolonged hospitalization, especially in statin naïve patients. The aim of this study is to investigate the effect of rosuvastatin loading dose on PPMI and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing elective PCI according to their statin use. Methods: One hundred sixty-five patients were included in the study and divided into two groups as patients already on statin treatment (n:126) and statin naive patients (n:39). Both groups were randomly assigned to high-dose (40 mg) rosuvastatin (n:86) or control group (n:79). The primary endpoint was the incidence of periprocedural myocardial infarction, and the secondary endpoint was MACCE. Results: The mean age of study population was 59±9.4 years. Most of them (n:127, 77%) were male. Median follow-up time was 368 day. There were 30 patients (19 in high dose statin group, and 11 in control group) diagnosed as PPMI after PCI. Loading dose of statin therapy was not effective to prevent occurrence of PPMI. A positive correlation between PPMI and creatinine (r:0.199, P:0.011), lesion complexity (r:0.189, p:0.015) and negative correlation between GFR and PPMI (r: -0.158 P=0.043) was remarkable. Conclusion: Pre-procedural administration of high dose rosuvastatin in patients with stable coronary artery disease has failed to decrease PPMI independent of chronic statin use.