Beneficial effects of statin treatment on coronary microvascular dysfunction and left ventricular remodeling in patients with acute myocardial infarction

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• 作者：Kentaro Ishida^a ; Toru Geshi^a ; ^{tgeshi@u-fukui.ac.jp} ; Akira Nakano^a ; Hiroyasu Uzui^a ; Yasuhiko Mitsuke^a ; Hidehiko Okazawa^b ; Takanori Ueda^a ; Jong-Dae Lee^a
• 关键词：ACE-I ; angiotensin-converting enzyme inhibitor ; ADMA ; asymmetric dimethylarginine ; AMI ; acute myocardial infarction ; ARB ; angiotensin II receptor blocker ; ATP ; adenosine triphosphate ; DBP ; diastolic blood pressure ; HDL-C ; high-density lipoprotein choleste
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：22 March, 2012
• 卷：155
• 期：3
• 页码：442-447
• 文件大小：591 K

摘要

Background

Statin treatment has been shown to improve coronary endothelial function, irrespective of lipid-lowering effects. This study's aim was to elucidate the effects of statin treatment on coronary microvascular dysfunction and left ventricular remodeling in acute myocardial infarction (AMI) patients.

Methods

Thirty-five patients undergoing successful reperfusion following AMI were assigned to a statin-treated (Group S, 16) or a non-statin-treated (Group NS, 19) group, according to fasting serum low-density lipoprotein-cholesterol. ¹³N-ammonia positron emission tomography was performed to assess myocardial flow reserve (MFR) in the infarct area.

Results

Infarct sizes and lipid profiles during the chronic period were similar between the two groups. At 2 weeks after AMI onset, mean MFR in the infarct area was significantly higher in Group S than in Group NS (2.34 卤 0.63 vs. 1.91 卤 0.43, p = 0.0214). At 6 months post-AMI, Group S had a smaller left-ventricular end-diastolic volume index (69.4 卤 11.7 mL/m² vs. 88.5 卤 32.5 mL/m², p = 0.0328) and higher left-ventricular ejection fraction (67.7 卤 9.2%vs. 59.2 卤 13.3%, p = 0.0394) than Group NS. Serum asymmetric dimethylarginine was significantly increased in Group NS at 1 month post-AMI (0.43 卤 0.12 渭mol/L (baseline) vs. 0.52 卤 0.14 渭mol/L, p = 0.0186), but unchanged in Group S.

Conclusions

Statin treatment appears to beneficially attenuate left ventricular remodeling after AMI, which may be associated with restoring coronary endothelial function via endogenous nitric oxide.