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- Title
The Effect of Statins on the No-Reflow Phenomenon: An Observational Study in Patients with Hyperglycemia before Primary Angioplasty.
- Authors
Jing-Lin Zhao; Yue-Jin Yang; Wei-Dong Pei; Yu-Hua Sun; Ji-Lin Chen
- Abstract
Background: An association between admission plasma glucose levels and an increased risk of no-reflow has been well documented. Although HMG-CoA reductase inhibitor (statin) therapy can reduce no-reflow, little is known about its effect on no-reflow in patients with hyperglycemia. In the present study, we investigated whether pretreatment with a statin could reduce no-reflow in patients with hyperglycemia, who underwent primary coronary intervention for acute myocardial infarction (AMI). Methods: A total of 259 consecutive patients who underwent primary angioplasty for a first AMI were studied. Blood glucose and creatinine kinase levels were measured on admission. All patients underwent 2-dimensional echocardiography and electrocardiographic analysis just after admission.No-reflowwas defined as a Thrombolysis in Myocardial Infarction (TIMI) flow grade <3. Hyperglycemia was defined as a blood glucose level ≤10 mmol/L. Statin administration prior to admission was determined by detailed interview or information in the medical records. Results: Hyperglycemia was diagnosed in 154 patients on admission. The no-reflow phenomenon was found in 31 of the 154 patients with hyperglycemia. The incidence of no-reflow was significantly greater in patients with hyperglycemia compared with no hyperglycemia. A multivariable logistic regression analysis showed that hyperglycemia on admission was an independent predictor of no-reflow. Among the 154 patients with hyperglycemia, there were no significant differences in baseline clinical characteristics between patients who received statin pretreatment and those who did not; however, hyperlipidemia occurred in a greater number of the patients who did not receive statin pretreatment. The 40 patients with hyperglycemia who received statins before admission had a lower incidence of no-reflow than those who did not receive statin pretreatment (5% and 25.4%; p < 0.05). Multivariable logistic regression analysis revealed that absence of statin pretreatment was a significant predictor of no-reflow in patients with hyperglycemia, along with ejection fraction on admission, initial TIMI 0 flow, number of Q waves, and anterior AMI. Conclusion: The results of our study show that pretreatment with statins could attenuate no-reflow after AMI in patients with acute hyperglycemia.
- Subjects
ANGIOPLASTY; STATINS (Cardiovascular agents); HYPERGLYCEMIA; MYOCARDIAL infarction; ECHOCARDIOGRAPHY
- Publication
American Journal of Cardiovascular Drugs, 2009, Vol 9, Issue 2, p81
- ISSN
1175-3277
- Publication type
Article
- DOI
10.1007/BF03256579