Statins Administered Before Primary Intervention Associated with Cardioprotective Effects

SAN FRANCISCO, CA—Statin therapy administered before primary intervention in acute myocardial infarction (AMI) patients was not associated with reduced risk of all-cause death and major adverse cardiac and cerebrovascular events (MACE) as presented by Mitsuhiro Shimomura, MD, and colleagues from the Department of Cardiovascular Medicine, Saga University in Saga, Japan. 

At ACC.13, the American College of Cardiology's 62nd Annual Scientific Session, Dr. Shimomura discussed results that atorvastatin displayed cardioprotective effects beyond its lipid lowering effects in patients with AMI and reduced the levels of angiopoietin-like protein2 (ANGPTL2) and toxic advanced glycation endproducts (TAGE).

ANGPTL2 has recently been identified as a chronic inflammation mediator, positively associated with Type 2 diabetes mellitus development and mortality. TAGE are associated with arthrosclerosis and hypertension progression including cardiovascular disease.

Acute myocardial infarction may cause cardiovascular morbidity and mortality. Investigators determined if HMG-CoA reductase inhibitor therapy before primary intervention could be beneficial in patients with acute myocardial infarction.

In this prospective, multicenter, randomized study, 201 patients receiving cardiac intervention due to an acute onset of AMI were enrolled. Patients were randomized to either the statin group (n=103) or placebo group (n=98). In the statin group, atorvastatin 40mg was administered before the primary intervention and then were given atorvastatin 10mg for 30 days. The primary endpoints for this study were all-cause death and major adverse cardiac and cerebrovascular events (MACCE), six months after an AMI.

Researchers found that 13 atorvastatin patients (13.7%) and 13 placebo patients (14.1%) experienced MACCE. Even though there were no significant differences in creatinine kinase peak levels, the ejection fraction, plasma levels of IL-6, TNF-α, PTX3 levels, ANGPTL2, and TAGE were decreased two weeks after atorvastatin therapy.

Statin therapy before primary intervention in patients experiencing acute myocardial infarction did not reduce the risk of all-cause death and MACCE. Dr. Shimomura noted atorvastatin having “cardioprotective effects greater that lipid lowering effects in AMI patients.”