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Effects of First High-Dose Atorvastatin Loading in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Li, Qiang, MM1; Zhao, Yong-Gang, MM2; Wang, Zhen, MM1; Jiang, Hai-Peng, MB3; Liu, Wen-Bo, MM3; Cao, Bing-Feng, MM4,*

American Journal of Therapeutics: May/June 2018 - Volume 25 - Issue 3 - p e291–e298
doi: 10.1097/MJT.0000000000000370
Original Article

To determine the effects of 80-mg atorvastatin administration for the first time in patients with acute ST segment elevation myocardial infarction (STEMI) before emergency percutaneous coronary intervention (PCI). A total of 118 patients with STEMI who underwent emergency PCI were enrolled in this study. The patients were divided into 80-mg group (n = 59) and 40-mg group (n = 59), according to the loading dose of atorvastatin firstly before operation. The occurrence of no-reflows and changes of HbA1c were observed preoperatively and postoperatively on second and fifth days. All patients were followed up for 1 year with major adverse cardiac events (MACE) recorded. The incidence of no-reflow in 80-mg group was obviously lower than in 40-mg group (13.56% vs. 25.42%) (χ2 = 4.374, P = 4.374). The preoperative HbA1c levels exhibited no significant difference between 80-mg group and 40-mg group (P > 0.05). The postoperative HbA1c levels in 2 groups showed a trend of gradual decline, which were lower in 80-mg group than in 40-mg group for second day, fifth day, first month, sixth month, and 12th month (all P < 0.05). The postoperative incidence of MACE in 80-mg group was significantly lower than in 40-mg group for sixth and 12th months (both P < 0.05). The incidence of MACE in patients with reflow in 80-mg and 40-mg groups was significantly higher than in patients with no-reflow who were in 80-mg and 40-mg groups for postoperative 12th month (both P < 0.05). The first loading high dose of atorvastatin can significantly prevent occurrence of postoperative no-reflow in patients with STEMI after PCI, reduce HbA1c levels and the incidence of MACE. Clinical randomized controlled trial with larger sample size is required to confirm this finding.

1Department of Cardiology, Yantaishan Hospital, Yantai, China;

2Second Division of Internal Medicine-Cardiovascular Department, the First Hospital of Zibo City, Zibo, China;

3Yantaishan Hospital, Yantai, China; and

4Department of Cardiology, Wendeng Central Hospital of Weihai, Weihai, China.

Address for correspondence: Department of Cardiology, Wendeng Central Hospital of Weihai, West of No. 3 Mishan East Road, Wendeng District, Weihai 264400, China. E-mail:

The authors have no conflicts of interest to declare.

Qiang Li and Yong-Gang Zhao are co-first authors.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.