European Heart Journal Advance Access originally published online on January 9, 2006
European Heart Journal 2006 27(5):534-539; doi:10.1093/eurheartj/ehi715
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Chronic pre-treatment of statins is associated with the reduction of the no-reflow phenomenon in the patients with reperfused acute myocardial infarction
Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka 5300001, Japan
Received 5 August 2005; revised 8 December 2005; accepted 15 December 2005; online publish-ahead-of-print 9 January 2006.
* Corresponding author. Tel: +81 6 6341 8651; fax: +81 6 6341 0785.E-mail address: itomd{at}osk4.3web.ne.jp
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.
Key Words: Statin • Acute myocardial infarction • Coronary microcirculation • Myocardial contrast echocardiography
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