Objective To evaluate the immediate protective effects of intensive statin pretreatment on myocardial perfusion and myocardial ischaemic injury during PCI.
Methods A total of 228 acute coronary syndrome (ACS) patients were randomly divided into standard statin group (SSG, n=115) and intensive statin group (ISG, n=113). Patients in SSG received 20 mg simvastatin and patients in ISG received80 mgsimvastatin for 7 days before PCI. TIMI grade flow (TGF), corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) of the intervened vessel were recorded before and after stent deployment. Plasma level of CK-MB and cTnI were measured before and 24 h after the procedure.
Results The TFG after stent deployment was significantly improved with less TIMI 0–1 patients and more TIMI 3 blood flow in ISG than in SSG (all p<0.05). Patients with no reflow phenomenon were less in ISG (p<0.001). The CTFC was lower in ISG than SSG (p<0.001). TMPG was also improved in ISG than SSG (p=0.001). Twenty-four hours after the procedure, although PCI caused significantly increase in CK-MB, the elevated CK-MB value was lower in ISG than SSG (18.74±8.41 vs 21.78±10.64 p=0.018). Similar changes were also found with regard to Troponin I (0.99±1.07 vs 1.47±1.54, p=0.006). No myocardial infarction was found. Among them, myocardial necrosis was detected in 13% of the patients in SSG, while 4.4% in ISG (p=0.021). Myocardial infarction was found in 4.4% in the patients in SSG and 0.9% in ISG (p=0.213).
Conclusion Intensive statin pretreatment for 7 days before PCI can further improve myocardial blood perfusion, protect myocardium from ischaemic injury.