Chaudhary Ahmed Jamal, Iqbal Sana, Khan Nisar Ahmad, Furrukh Anshaal, Bano Shah, Ali Muhammad Nasir, Ali Afaq, Khan Sajjad Ullah
Medicine / Transitional Medicine, Detroit Medical Center (DMC) Sinai-Grace Hospital, Detroit, USA.
Medicine, Lahore Medical and Dental College, Lahore, PAK.
Cureus. 2024 Nov 20;16(11):e74076. doi: 10.7759/cureus.74076. eCollection 2024 Nov.
Primary percutaneous coronary intervention (PCI) is crucial in managing acute ST-segment elevation myocardial infarction (STEMI), emphasizing the importance of optimal myocardial reperfusion.
The goal of this research was to determine how loading doses of rosuvastatin and atorvastatin affected the flow rate of thrombolysis in myocardial infarction (TIMI) immediately post-perfusion thrombolysis in patients undergoing primary PCI.
This prospective, comparative study was carried out over a one-year period (January 2023 to December 2023) in Pakistan. Data was gathered from patient interviews and electronic medical records for adult patients receiving primary PCI. Interventional cardiologists who were blinded to the evaluation of the immediate post-perfusion TIMI flow conducted statistical analysis to compare the results between the two statin groups.
Both groups had good procedural success rates: 184 patients (92.00%) in the group using rosuvastatin and 179 patients (89.50%) in the group on atorvastatin (p = 0.284). A comparable use of auxiliary equipment was seen, with 103 patients (51.50%) and 97 patients (48.50%) in the atorvastatin group and 108 patients (54.00%) and 92 patients (46.00%) in the rosuvastatin group, respectively (p = 0.53). There were no notable variations in the immediate post-perfusion TIMI flow grades either, with p-values of 0.532 for normal flow and 0.421 for no-reflow. The two groups' mean lengths of hospital stays were comparable, measuring 3.5 days (± 1.2) for the rosuvastatin group and 3.8 days (± 1.3) for the atorvastatin group (p = 0.321).
Rosuvastatin and atorvastatin had comparable rapid post-perfusion TIMI flows in the initial PCI participants, indicating that they may be used interchangeably to maximize myocardial reperfusion in acute STEMI.
直接经皮冠状动脉介入治疗（PCI）在急性ST段抬高型心肌梗死（STEMI）的管理中至关重要，强调了最佳心肌再灌注的重要性。
本研究的目的是确定瑞舒伐他汀和阿托伐他汀的负荷剂量如何影响接受直接PCI的患者在灌注溶栓后即刻的心肌梗死溶栓（TIMI）血流速度。
这项前瞻性比较研究在巴基斯坦进行了一年（2023年1月至2023年12月）。数据收集自接受直接PCI的成年患者的访谈和电子病历。对灌注后即刻TIMI血流评估不知情的介入心脏病专家进行统计分析，以比较两个他汀类药物组的结果。
两组的手术成功率都很高：使用瑞舒伐他汀的组中有184例患者（92.00%），使用阿托伐他汀的组中有179例患者（89.50%）（p = 0.284）。辅助设备的使用情况相当，阿托伐他汀组分别有103例患者（51.50%）和97例患者（48.50%），瑞舒伐他汀组分别有108例患者（54.00%）和92例患者（46.00%）（p = 0.53）。灌注后即刻的TIMI血流分级也没有显著差异，正常血流的p值为0.532，无复流的p值为0.421。两组的平均住院时间相当，瑞舒伐他汀组为3.5天（±1.2），阿托伐他汀组为3.8天（±1.3）（p = 0.321）。
在初始PCI参与者中，瑞舒伐他汀和阿托伐他汀在灌注后即刻的TIMI血流相当，表明它们在急性STEMI中可互换使用以实现最大程度的心肌再灌注。
