Background: Statin therapy after percutaneous coronary intervention (PCI) is associated with reduced mortality and recurrent ischemia. We studied that effect of chronic statin therapy more than 1 month before PCI on the outcome of the patients with acute coronary syndrome (ACS) underwent PCI.
Methods: We stratified 479 consecutive patients with ACS who underwent PCI according to the preprocedural status of statin therapy (237 chronic statin-treated and 242 control patients). Incidence of periprocedural myocardial infarction (MI) was assessed by analysis of creatinine kinase-MB and cardiac troponin T before and 8, 16, and 24 hours after the intervention.
Results: Chronic statin-treated ACS patients revealed lower baseline serum troponin and fibrinogen levels. Incidence of Braunwald class III angina and MI presentation were significantly lower in statin-treated patients than in control patients. Angiographic and procedural characteristics were similar between the two groups, but slow/no reflow phenomenon was more frequently occurred in statin-treated patients. After PCI, incidence of periprocedural myocardial injury was higher in control patients than in statin-treated patients (6.6% versus 2.1%, p=0.016). Baseline high sensitivity C-reactive protein (hsCRP) levels were similar between the two groups, whereas after PCI, peak values of hsCRP was elevated significantly higher in control patients than in statin-treated patients. Multivariate analysis revealed that no prior use of statin (OR=4.0; 95% CI=1.3-12.8; p=0.018), procedural complication (OR=4.8; 95% CI=1.6-14.0; p=0.004) and stent overlap (OR=7.9; 95% CI=1.8-34.4; p=0.005) were the independent predictors for periprocedural myocardial infarction.
Conclusion: Chronic statin therapy before ACS was associated with milder clinical presentation and lower incidence of periprocedural myocardial injury after PCI.