Abstract
Background
In animal models, pretreatment with statin can prevent reperfusion arrhythmia. In the observational study, we investigated whether pretreatment with statin may prevent reperfusion arrhythmia in patients who underwent primary coronary intervention for acute myocardial infarction (AMI).
Method and results
A total of 226 consecutive patients who underwent successful primary angioplasty for a first AMI were studied. Reperfusion arrhythmias were defined as all arrhythmias that occurred within 2 h after successful primary angioplasty. The reperfusion arrhythmia was found in 130 of 226 patients. There were no significant differences in clinical characteristics between the patients with and without statin pretreatment. However, the 41 patients receiving statin treatment before admission had lower incidence of the reperfusion arrhythmia than those without it (19.5% and 65.9%, P < 0.01). Multivariable logistic regression analysis revealed that absence of statin pre-treatment was a significant predictor of the reperfusion arrhythmia along with absence of pre-infarction angina and inferior AMI.
Conclusion
Pre-treatment with statin could reduce the reperfusion arrhythmias after acute myocardial infarction in human.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chan AW, Bhatt DL, Chew DP et al (2003) Relation of inflammation and benefit of statins after percutaneous coronary interventions. Circulation 107:1750–1756
Chen JG, Nagasawa Y, Zhu BM et al (2003) Pravastatin prevents arrhythmias induced by coronary artery ischemia/reperfusion in anesthetized normocholesterolemic rats. J Pharmacol Sci 93:87–94
Chesebro JH, Knatterud G, Roberts R et al (1987) Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation 76:142–154
Goldberg S, Greenspon AJ, Urban PL et al (1983) Reperfusion arrhythmia: a marker of restoration of antegrade flow during intracoronary thrombolysis for acute myocardial infarction. Am Heart J 105:26–32
Goldberger JJ, Subacius H, Schaechter A et al (2006) Effects of statin therapy on arrhythmic events and survival in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol 48:1228–1233
Henriques JPS, Gheeraert PG, Ottervanger JP et al (2005) Ventricular fibrillation in acute myocardial infarction before and during primary PCI. Int J Cardiol 105:262–266
Itoh T, Fukami KI, Suzuki T et al (2006) Effect of pre-myocardial infarction angina pectoris on post-myocardial infarction arrhythmias after reperfusion therapy. Am J Cardiol 97:1157–1161
Keeley EC, Boura JA, Grines CL (2003) Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 361:13–20
Keeley EC, Grines CL (2004) Primary percutaneous coronary intervention for every patient with ST-segment elevation myocardial infarction: what stands in the way? Ann Intern Meds 141:298–304
Manning AS, Hearse DJ (1984) Reperfusion-induced arrhythmias: mechanisms and prevention. J Mol Cell Cardiol 16:497–518
Mark L., Katona A (2000) Effect of fluvastatin on QT dispersion: a new pleiotropic effect? Am J Cardiol 85:919–920
Obermaier R, von Dobschuetz E, Drognitz O et al (2004) Ischemic preconditioning attenuates capillary no-reflow and leukocyte adherence in postischemic pancreatitis. Langenbecks Arch Surg 389:511–516
Papadopoulos CE, Karvounis HI, Parharidis GE et al (2003) Preconditioning reduces QTc value in patients with first non-ST-segment elevation myocardial infarction (NSTEMI). Ann Noninvasive Electrocardiol 8:275–283
Patti G, Chello M, Candura D et al (2006) Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study. Circulation 114:1455–1461
Pehlivanidis AN, Athyros VG, Demitriadis DS et al (2001) Heart rate variability after long-term treatment with atorvastatin in hypercholesterolaemic patients with or without coronary artery disease. Atherosclerosis 157:463–469
Rentrop KP, Cohen M, Blanke H et al (1985) Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 5:587–592
Rupprecht HJ (2006) Cardiovascular secondary prevention. Clin Res Cardiol 95(Suppl 6):VI1–VI5
Wan MX, Schramm R, Klintman D et al (2003) A statin-based inhibitor of lymphocyte function antigen-1 protects against ischemia/reperfusion-induced leukocyte adhesion in the colon. Br J Pharmacol 140:395–401
Wassmann S, Laufs U, Baumer AT et al (2001) HMG-CoA reductase inhibitors improve endothelial dysfunction in normocholesterolemic hypertension via reduced production of reactive oxygen species. Hypertension 37:1450–1457
Zhao JL, Yang YJ, Cui CJ et al (2006) Pretreatment with simvastatin reduces myocardial no-reflow by opening mitochondrial K(ATP) channel. Br J Pharmacol 149:243–249
Acknowledgments
Supported, in part, by a Grant-in-Aid (30572439) from the National Natural Science Foundation of China.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhao, Jl., Yang, Yj., Pei, Wd. et al. Effect of statin therapy on reperfusion arrhythmia in patients who underwent successful primary angioplasty. Clin Res Cardiol 97, 147–151 (2008). https://doi.org/10.1007/s00392-007-0606-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00392-007-0606-9