Background Previous studies have shown that statin therapy improves prognosis in patients with acute coronary syndrome (ACS). However, there is not enough data regarding the effects of statin loading before percutensous coronary intervention (PCI) on coronary blood flow in patients with ACS.
Methods Consecutive 407 patients with ACS who underwent PCI were randomly assigned to either the group of no statin treatment before PCI (Control group, n=199) or the group of 40 mg rosuvastatin loading before PCI (Rosuvastatin group, n=208). Coronary blood flow was determined by TIMI frame count method using the angiographic images obtained just after PCI.
Results Rosuvastatin 40 mg loading was performed for 16 짹 5 hours (range 7~25 hours) prior to the index procedure. Corrected TIMI frame count was significantly lower in patients treated 40mg rosuvastatin loading before PCI compared with in those without statin treatment (24.1 짹 10.4 vs. 20.9 짹 6.3, p=0.001). Multivariate analysis revealed that impaired coronary flow after PCI were associated with rosuvastatin loading (HR 0.6, 95% CI = 0.3-0.9, p = 0.014), smoking (HR 1.9, 95% CI = 1.2-3.0, p = 0.010) and stent overlap (HR 2.1, 95% CI = 1.1-4.2, p = 0.030).
Conclusions High dose rosuvastatin loading before PCI improves coronary blood flow after PCI in patients with ACS undergoing early invasive strategy.