Chronic pre-treatment of statins is associated with the reduction of the no-reflow phenomenon in the patients with reperfused acute myocardial infarction

Katsuomi Iwakura, Hiroshi Itoh, Shigeo Kawano, Atsushi Okamura, Toshiya Kurotobi, Motoo Date, Koichi Inoue, Kenshi Fujii

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Abstract

Aims: Early statin treatment has beneficial effects on prognosis after acute coronary syndrome. The no-reflow phenomenon determines the prognosis after acute myocardial infarction. We investigated the effects of statin treatment before admission on the development of the no-reflow after infarction. Methods and results: We performed intracoronary myocardial contrast echocardiography in 293 consecutive patients with acute myocardial infarction undergoing successful primary percutaneous coronary intervention. There were no significant differences in the incidence of the no-reflow between the patients with and without hypercholesterolaemia. The 33 patients receiving chronic statin treatment before admission had lower incidence of the no-reflow than those without it (9.1 and 34.6%, P = 0.003). They also showed better wall motion, smaller left ventricular dimensions, and better ejection fraction at 4.9 ± 2.2 months later. Multivariable logistic regression analysis revealed that statin pre-treatment was a significant predictor of the no-reflow along with anterior wall infarction, ejection fraction on admission, and additional ST-elevation after reperfusion, whereas total cholesterol was not. Conclusion: Chronic pre-treatment with statins could preserve the microvascular integrity after acute myocardial infarction independent of lipid lowering, leading to better functional recovery.

Original languageEnglish
Pages (from-to)534-539
Number of pages6
JournalEuropean Heart Journal
Volume27
Issue number5
DOIs
Publication statusPublished - Mar 2006
Externally publishedYes

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Keywords

  • Acute myocardial infarction
  • Coronary microcirculation
  • Myocardial contrast echocardiography
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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