Objectives and Background Statin therapy after percutaneous coronary intervention (PCI) has

Objectives and Background Statin therapy after percutaneous coronary intervention (PCI) has been associated with reduced major adverse cardiovascular events (MACE). assessed. Results The incidence of Braunwald class III angina and MI presentation were significantly lower in the statin group than in the control group. Angiographic and procedural characteristics were similar between the two groups; however, slow/no reflow phenomenon occurred more in the control group frequently. After PCI, the incidence of periprocedural MI was higher in the control group than in the statin group (6.6% vs. 2.1%, p=0.016). Multivariate analysis revealed that no prior use of statin {odds ratio (OR)=2.8; 95% confidence interval (CI)=1.1-7.2; p=0.038), procedural complication (OR=4.0; 95% CI=1.5-10.5; p=0.004), stent overlap (OR=4.7; 95% CI=1.3-16.4; p=0.015), and old age (OR=3.2; 95% CI=1.2-8.0; p=0.016) were independent predictors for in-hospital MACE. Conclusion Previous statin therapy before ACS was associated with milder clinical presentation and lower incidence of in-hospital MACE after early invasive strategies. The beneficial outcome is attributable to a significant reduction in periprocedural MI after PCI. Keywords: Angioplasty, AN-2690 manufacture Myocardial infarction, Stents, Hydroxymethylglutaryl-coenzyme A reductase inhibitors, Treatment outcome Introduction Statins have been known to reduce cardiovascular clinical events in a variety of patients significantly, ranging from those with established cardiovascular disease to those who are at risk for cardiovascular disease.1-6) The role of statins in patients with acute coronary syndrome (ACS) also has been clarified. Large scaled randomized trials have shown that early and high doses of statin therapy significantly improve FST the prognosis in patients with ACS.7),8) Since an early invasive strategy has been the standard therapy for ACS, several studies have been conducted to determine whether periprocedural use of statins is beneficial in these full cases. Some reports have suggested that statin loading prior to percutaneous coronary intervention (PCI) is associated with AN-2690 manufacture reduced mortality and decreased periprocedural myocardial injury after PCI in patients with ACS.9),10) Another study demonstrated that pretreatment with statin for three to seven days in patients with ACS was associated with a reduction of myocardial necrosis and late cardiac events after PCI.11),12) However, it has been less clear as to whether statin therapy before a coronary event is beneficial. Therefore, we designed a retrospective study involving consecutive ACS patients who underwent PCI. We compared the hospital course and mortality between those patients who had undergone previous statin treatment for more than one month, which was set to avoid statin therapy after the occurrence of ACS and to enroll patients showing the lipid lowering effect of statin, as well as patients without statin pretreatment. Subjects and Methods Study population We analyzed a single center ACS and PCI cohort from December 2008 to December 2009. During the study period, 479 consecutive patients were followed-up and recruited during their clinical course to document patient characteristics, acute therapy, PCI data, and hospital outcome. According to the AN-2690 manufacture patient’s past medication history, the patients were divided by us into two groups, and compared their hospital course. Two hundred thirty-seven patients had previously undergone statin treatment for more than one month prior to PCI (statin group) and 242 patients were statin-naive patients (control group). All patients gave informed consent for processing their anonymous data according to a protocol approved by the Institutional Review Board of Wonkwang University Hospital. Percutaneous coronary intervention PCI was performed according to the current clinical practice at the physician’s discretion and within 48 hours after admission. In all patients, aspirin (300 mg/day) and clopidogrel (300 mg/day) were loaded before the procedure. An intravenous bolus of 5,000 U of unfractionated AN-2690 manufacture heparin was given, and then additional heparin was given to maintain an activated clotting time greater than 300 s during the procedure. Platelet glycoprotein IIb/IIIa inhibitors (GPI) were administered according to operator preference. Post-procedural management Aspirin (100 mg/day), clopidogrel (75 mg/day) and statins were prescribed to all patients following the procedure. Creatine kinase MB fraction (CK-MB) and troponin T were measured before (at admission, mean 184 hours before PCI), and at 8, AN-2690 manufacture 16, and 24 hours after PCI. High-sensitivity C-reactive protein (hsCRP) and fibrinogen were also assessed before PCI and at 24 hours after PCI. Definitions Periprocedural myocardial infarction (MI) was defined as a postprocedural increase of CK-MB more than three times higher than the normal upper.