Effect of High Loading Dose of Atorvastatin in ST Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention on Microvascular Perfusion Measured by Index of Microvascular Resistance

Background: Statin (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors), given before percutaneous coronary intervention (PCI) was proven to reduce Major Cardiovascular Events (MCE) in patient with stable angina as well as acute coronary syndromes through its pleiotropic effect. Nevertheless, the debate regarding statin administration before primary PCI (PPCI) in STEMI patients is still on the rise. The aim of this study is to establish therapeutic effect of high dose atorvastatin (80 mg) and placebo before primary PCI on microvascular perfusion in STEMI patient using index of microcirculatory resistance (IMR). IMR are specific and quantitative assessment of coronary microvascular dysfunction, reliable on-site predictors of short-term myocardial viability and left ventricle functional recovery of patients undergoing primary PCI for STEMI Methods: This study is a double blind randomized controlled trial. A high loading dose of atorvastatin (80 mg) or placebo was administered before PPCI. Samples were taken from the population of STEMI patients which underwent PPCI and meet inclusion and exclusion criteria. The primary end point of this study is IMR. After successful primary percutaneous coronary intervention, IMR was measured using a pressure-temperature sensor-tipped coronary guidewire.