Background High dose statin loading therapy before percutaneous coronary intervention (PCI) is associated with reduced incidence of short-term adverse events and periprocedural myocardial infarction (MI). However, the long-term effects have not been evaluated.
Methods Consecutive 445 patients with ACS who underwent PCI were randomly assigned to either the group of no statin treatment before PCI (Control group, n=220) or the group of 40 mg rosuvastatin loading before PCI (Rosuvastatin group, n=225). The primary end point was the occurrence of major adverse cardiac events (MACEs) including cardiac death, non-fatal MI, non-fatal stroke, and any revascularization during 12 months.
Results The primary end point occurred in 20.9% of the control group patients and in 9.8% of the rosuvastatin group patients (p = 0.001). The Kaplan-Meier curves showed that the incidence of death and non-fatal MI was higher in the control group than in the rosuvastatin group (hazard ratio 3.71, p = 0.021). After rosuvastatin loading, high sensitivity C-reactive protein levels were less elevated in the rosuvastatin group at 24 hours after PCI. Multivariate analysis revealed that rosuvastatin loading was the independent predictor for decreased risk of MACEs at 12 months (odds ratio = 0.4, 95% confidence interval = 0.2-0.8, p = 0.004).
Conclusions High dose rosuvastatin loading before PCI improves the 12 months clinical outcomes in patients with ACS undergoing early invasive strategy.