Early statin treatment prior to primary PCI for acute myocardial infarction: REPERATOR, a randomized placebo-controlled pilot trial

Catheterization and Cardiovascular Interventions, 04/19/2012

In this pilot study, pretreatment with atorvastatin in an acute myocardial infarction does not result in an improved cardiac function, microvascular perfusion, or decreased myocardial infarct size.

Methods

  • 42 consecutive patients (82% male, mean age 61.2 ± 9.8) who underwent a primary PCI for a first ST–elevated AMI were randomized for pretreatment with atorvastatin 80 mg (n = 20) or placebo (n = 22) and continued with the same dosage daily for 1 week.
  • All patients received atorvastatin 80 mg once daily 7 days after primary PCI.
  • The LV function and infarct size were measured by magnetic resonance imaging within 1 day, at 1 week, and 3 months follow up.
  • The primary endpoint was the end–systolic volume index (ESVI) at 3 months.
  • Secondary endpoints were global LV function measurements, myocardial infarct size, biochemical cardiac markers, TIMI flow, and ST–T elevation resolution.

Results

  • ESVI 3 months after AMI was 25.1 mL/m2 in the atorvastatin arm and 25.0 mL/m2 in the placebo arm (P = 0.74).
  • The differences in change from baseline to 3 months follow up in global LV function and myocardial infarct size did not differ between both treatment arms.
  • Furthermore, biochemical markers, TIMI flow, and ST–T elevation resolution did not differ between atorvastatin and placebo arm.

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