Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction

Joerg Herrmann, Amir Lerman, Dietrich Baumgart, Lothar Volbracht, Rainer Schulz, Clemens Von Birgelen, Michael Haude, Gerd Heusch, Raimund Erbel

Research output: Contribution to journalArticleAcademicpeer-review

156 Citations (Scopus)

Abstract

Background - Stenting-related myocardial injury has been recognized as a frequent and prognostically important event, the extent of which depends on microcirculatory impairment in association with platelet aggregations, inflammation, and increased oxidative stress. Recent studies underscored the non-lipid-lowering effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) with antithrombotic, antiinflammatory and antioxidative aspects. Thus, we tested the hypothesis that preprocedural statin therapy is associated with a reduction in the extent of stenting-related myocardial injury. Methods and Results - We stratified 296 consecutive patients who were undergoing stenting of a de novo stenosis according to the preprocedural status of statin therapy (229 statin-treated and 67 control patients). Incidence of periprocedural myocardial injury was assessed by analysis of creatine kinase (CK; upper limit of normal [ULN] 70 IU/L for women, 80 IU/L for men) and cardiac troponin T (cTnT; bedside test; threshold 0.1 ng/mL) before and 6, 12, and 24 hours after the intervention. Relative to control patients, the incidence of CK elevation >3× ULN was more than 90% lower in statin-treated patients (0.4% versus 6.0%, P= 0.01). Statin therapy was the only factor independently associated with a lower risk of CK elevation >3× ULN (OR: 0.08, 95% CI: 0.01 to 0.75; P=0.03). The overall incidences of CK and cardiac troponin T elevation were slightly lower in statin-treated than in control patients (14.4% versus 20.9%, P=0.3, and 17.9% versus 22.4%, P=0.5, respectively). Conclusions - Preprocedural statin therapy is associated with a reduction in the incidence of larger-sized, stenting-related myocardial infarctions. Prospective, randomized trials are warranted to further assess this cardioprotective effect of statins in coronary intervention.

Original languageEnglish
Pages (from-to)2180-2183
Number of pages4
JournalCirculation
Volume106
Issue number17
DOIs
Publication statusPublished - 22 Oct 2002
Externally publishedYes

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Myocardial Infarction
Troponin T
Incidence
Wounds and Injuries
Therapeutics
Creatine Kinase
Platelet Aggregation
Oxidoreductases
Pathologic Constriction
Oxidative Stress
Anti-Inflammatory Agents
Inflammation

Keywords

  • Creatine kinase
  • Inhibitors
  • Myocardial infarction
  • Stents

Cite this

Herrmann, Joerg ; Lerman, Amir ; Baumgart, Dietrich ; Volbracht, Lothar ; Schulz, Rainer ; Von Birgelen, Clemens ; Haude, Michael ; Heusch, Gerd ; Erbel, Raimund. / Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction. In: Circulation. 2002 ; Vol. 106, No. 17. pp. 2180-2183.
@article{12a004585a9041d8825ad439969454b0,
title = "Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction",
abstract = "Background - Stenting-related myocardial injury has been recognized as a frequent and prognostically important event, the extent of which depends on microcirculatory impairment in association with platelet aggregations, inflammation, and increased oxidative stress. Recent studies underscored the non-lipid-lowering effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) with antithrombotic, antiinflammatory and antioxidative aspects. Thus, we tested the hypothesis that preprocedural statin therapy is associated with a reduction in the extent of stenting-related myocardial injury. Methods and Results - We stratified 296 consecutive patients who were undergoing stenting of a de novo stenosis according to the preprocedural status of statin therapy (229 statin-treated and 67 control patients). Incidence of periprocedural myocardial injury was assessed by analysis of creatine kinase (CK; upper limit of normal [ULN] 70 IU/L for women, 80 IU/L for men) and cardiac troponin T (cTnT; bedside test; threshold 0.1 ng/mL) before and 6, 12, and 24 hours after the intervention. Relative to control patients, the incidence of CK elevation >3× ULN was more than 90{\%} lower in statin-treated patients (0.4{\%} versus 6.0{\%}, P= 0.01). Statin therapy was the only factor independently associated with a lower risk of CK elevation >3× ULN (OR: 0.08, 95{\%} CI: 0.01 to 0.75; P=0.03). The overall incidences of CK and cardiac troponin T elevation were slightly lower in statin-treated than in control patients (14.4{\%} versus 20.9{\%}, P=0.3, and 17.9{\%} versus 22.4{\%}, P=0.5, respectively). Conclusions - Preprocedural statin therapy is associated with a reduction in the incidence of larger-sized, stenting-related myocardial infarctions. Prospective, randomized trials are warranted to further assess this cardioprotective effect of statins in coronary intervention.",
keywords = "Creatine kinase, Inhibitors, Myocardial infarction, Stents",
author = "Joerg Herrmann and Amir Lerman and Dietrich Baumgart and Lothar Volbracht and Rainer Schulz and {Von Birgelen}, Clemens and Michael Haude and Gerd Heusch and Raimund Erbel",
year = "2002",
month = "10",
day = "22",
doi = "10.1161/01.CIR.0000037520.89770.5E",
language = "English",
volume = "106",
pages = "2180--2183",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "17",

}

Herrmann, J, Lerman, A, Baumgart, D, Volbracht, L, Schulz, R, Von Birgelen, C, Haude, M, Heusch, G & Erbel, R 2002, 'Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction' Circulation, vol. 106, no. 17, pp. 2180-2183. https://doi.org/10.1161/01.CIR.0000037520.89770.5E

Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction. / Herrmann, Joerg; Lerman, Amir; Baumgart, Dietrich; Volbracht, Lothar; Schulz, Rainer; Von Birgelen, Clemens; Haude, Michael; Heusch, Gerd; Erbel, Raimund.

In: Circulation, Vol. 106, No. 17, 22.10.2002, p. 2180-2183.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Preprocedural statin medication reduces the extent of periprocedural non-Q-wave myocardial infarction

AU - Herrmann, Joerg

AU - Lerman, Amir

AU - Baumgart, Dietrich

AU - Volbracht, Lothar

AU - Schulz, Rainer

AU - Von Birgelen, Clemens

AU - Haude, Michael

AU - Heusch, Gerd

AU - Erbel, Raimund

PY - 2002/10/22

Y1 - 2002/10/22

N2 - Background - Stenting-related myocardial injury has been recognized as a frequent and prognostically important event, the extent of which depends on microcirculatory impairment in association with platelet aggregations, inflammation, and increased oxidative stress. Recent studies underscored the non-lipid-lowering effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) with antithrombotic, antiinflammatory and antioxidative aspects. Thus, we tested the hypothesis that preprocedural statin therapy is associated with a reduction in the extent of stenting-related myocardial injury. Methods and Results - We stratified 296 consecutive patients who were undergoing stenting of a de novo stenosis according to the preprocedural status of statin therapy (229 statin-treated and 67 control patients). Incidence of periprocedural myocardial injury was assessed by analysis of creatine kinase (CK; upper limit of normal [ULN] 70 IU/L for women, 80 IU/L for men) and cardiac troponin T (cTnT; bedside test; threshold 0.1 ng/mL) before and 6, 12, and 24 hours after the intervention. Relative to control patients, the incidence of CK elevation >3× ULN was more than 90% lower in statin-treated patients (0.4% versus 6.0%, P= 0.01). Statin therapy was the only factor independently associated with a lower risk of CK elevation >3× ULN (OR: 0.08, 95% CI: 0.01 to 0.75; P=0.03). The overall incidences of CK and cardiac troponin T elevation were slightly lower in statin-treated than in control patients (14.4% versus 20.9%, P=0.3, and 17.9% versus 22.4%, P=0.5, respectively). Conclusions - Preprocedural statin therapy is associated with a reduction in the incidence of larger-sized, stenting-related myocardial infarctions. Prospective, randomized trials are warranted to further assess this cardioprotective effect of statins in coronary intervention.

AB - Background - Stenting-related myocardial injury has been recognized as a frequent and prognostically important event, the extent of which depends on microcirculatory impairment in association with platelet aggregations, inflammation, and increased oxidative stress. Recent studies underscored the non-lipid-lowering effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) with antithrombotic, antiinflammatory and antioxidative aspects. Thus, we tested the hypothesis that preprocedural statin therapy is associated with a reduction in the extent of stenting-related myocardial injury. Methods and Results - We stratified 296 consecutive patients who were undergoing stenting of a de novo stenosis according to the preprocedural status of statin therapy (229 statin-treated and 67 control patients). Incidence of periprocedural myocardial injury was assessed by analysis of creatine kinase (CK; upper limit of normal [ULN] 70 IU/L for women, 80 IU/L for men) and cardiac troponin T (cTnT; bedside test; threshold 0.1 ng/mL) before and 6, 12, and 24 hours after the intervention. Relative to control patients, the incidence of CK elevation >3× ULN was more than 90% lower in statin-treated patients (0.4% versus 6.0%, P= 0.01). Statin therapy was the only factor independently associated with a lower risk of CK elevation >3× ULN (OR: 0.08, 95% CI: 0.01 to 0.75; P=0.03). The overall incidences of CK and cardiac troponin T elevation were slightly lower in statin-treated than in control patients (14.4% versus 20.9%, P=0.3, and 17.9% versus 22.4%, P=0.5, respectively). Conclusions - Preprocedural statin therapy is associated with a reduction in the incidence of larger-sized, stenting-related myocardial infarctions. Prospective, randomized trials are warranted to further assess this cardioprotective effect of statins in coronary intervention.

KW - Creatine kinase

KW - Inhibitors

KW - Myocardial infarction

KW - Stents

UR - http://www.scopus.com/inward/record.url?scp=0037159313&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.0000037520.89770.5E

DO - 10.1161/01.CIR.0000037520.89770.5E

M3 - Article

VL - 106

SP - 2180

EP - 2183

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 17

ER -