Impact of High Intensity Statin Preloading on Outcome of Primary Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction

Background: Worldwide, ischemic heart disease (IHD) is the single most common cause of death, and its frequency is increasing, now Accounts for almost 1.8 million annual deaths. This study aimed to determine the impact of high intensity statin preloading on angiographic and electrocardiographic outcome of primary percutaneous coronary intervention in patients with ST elevation myocardial infarction (STEMI). Methods: This single center, prospective open label randomized controlled study was conducted on 210 patients with STEMI who was planned for primary percutaneous intervention at the Department of Cardiology, Universal Health Insurance Tertiary hospital, Port Said in the duration from May 2023 to May 2024. patients were randomized into three groups at a ratio of 1:1:1. We used simple randomization method: Opaque sealed envelopes containing sequential numbers were given to the study patients, according to which each patient was enrolled to one of the three groups: Group I (N=70): Patients did not receive statin before primary percutaneous coronary intervention (PPCI), Group II (N=70): Patients received 80 mg atorvastatin single dose before PPCI, and Group III (N=70): Patients received 40 mg rosuvastatin single dose before PPCI. Results: Hypertension and Atorvastatin/ Rosuvastatin were the only significant predictors for the changes in corrected TIMI frame count (CTFC). Diabetes mellitus and Atorvastatin/ Rosuvastatin were the only significant predictors for the changes in Myocardial blush grade (MBG). Conclusion: Administering atorvastatin 80mg or Rosuvastatin 40mg before primary PCI in acute MI patients significantly improved angiographic outcomes (CTFC, TIMI flow grade, and MBG) and electrocardiographic outcomes than no statin therapy.