1
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2
National Heart Institute, Cairo, Egypt.
Abstract
Background: Percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for acute coronary syndrome. However, no-reflow can still occur and is associated with worse in-hospital and long-term prognoses. This study aims to assess the impact of high-dose atorvastatin loading before primary PCI on ST-elevation myocardial infarction (STEMI) patients with no-reflow and major adverse cardiovascular events (MACE) after 1 month.
Methods: Two hundred STEMI patients undergoing primary PCI were allocated and randomized into 2 groups: the study group received high-intensity statin (80 mg of atorvastatin) in addition to guideline-recommended therapy before primary PCI, while the control group received guideline-recommended therapy before primary PCI. Angiographic and echocardiographic assessments were thoroughly conducted for both groups.
Results: No significant differences in demographic data were observed between the 2 groups. A significant decrease in the no-reflow phenomenon was seen in the study group compared with the control group (28% vs 47%; P = 0.006). Moreover, a better myocardial blush grade was noted in the study group (0–1: 28% vs 43% and 2–3: 72% vs 57%; P = 0.027), along with a higher ejection fraction 24 hours after PCI (mean ± SD = 48.35 ± 8.78 vs 45.20 ± 7.89; P = 0.008) and improved ejection fraction after 1 month (43% vs 20%; P = 0.039). Nonetheless, no significant impact on MACE was found after 1 month.
Conclusions: High-dose atorvastatin loading before primary PCI led to improvements in postprocedural myocardial blush grade, the no-reflow phenomenon, and ejection fraction (both after 24 hours and 1 month). Still, no significant reduction in MACE was observed after 1 month. Despite this, our findings support the routine use of high-dose atorvastatin before primary PCI in patients presenting with STEMI. (Iranian Heart Journal 2025; 26(1): 54-66)
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Hennawy,B. S., Mohammed,A. and Fouad,K. A (2025). The Relationship Between High-Dose Atorvastatin Loading and the No-Reflow Phenomenon in STEMI Patients Undergoing Primary PCI. Iranian Heart Journal, 26(1), 54-66.
MLA
Hennawy,B. S., , Mohammed,A. , and Fouad,K. A. "The Relationship Between High-Dose Atorvastatin Loading and the No-Reflow Phenomenon in STEMI Patients Undergoing Primary PCI", Iranian Heart Journal, 26, 1, 2025, 54-66.
HARVARD
Hennawy B. S., Mohammed A., Fouad K. A (2025). 'The Relationship Between High-Dose Atorvastatin Loading and the No-Reflow Phenomenon in STEMI Patients Undergoing Primary PCI', Iranian Heart Journal, 26(1), pp. 54-66.
CHICAGO
B. S. Hennawy, A. Mohammed and K. A Fouad, "The Relationship Between High-Dose Atorvastatin Loading and the No-Reflow Phenomenon in STEMI Patients Undergoing Primary PCI," Iranian Heart Journal, 26 1 (2025): 54-66,
VANCOUVER
Hennawy B. S., Mohammed A., Fouad K. A The Relationship Between High-Dose Atorvastatin Loading and the No-Reflow Phenomenon in STEMI Patients Undergoing Primary PCI. Iranian Heart Journal, 2025; 26(1): 54-66.
