COMPARING THE EFFECTS OF LOADING DOSE OF ROSUVASTATIN VS ATORVASTATIN ON IMMEDIATE POST-PERFUSION TIMI FLOW IN PRIMARY PCI PATIENTS
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Keywords
Rosuvastatin, Atorvastatin, TIMI flow, Primary PCI, Acute Coronary Syndrome, Major Adverse Cardiovascular Events
Abstract
Background: Acute coronary syndrome (ACS) requires rapid intervention to restore blood flow, often achieved through primary percutaneous coronary intervention (PCI). Statins like rosuvastatin and atorvastatin are commonly used during PCI for their cholesterol-lowering and plaque-stabilizing effects. However, the specific impact of loading doses of these statins on immediate post-perfusion TIMI (Thrombolysis in Myocardial Infarction) flow has not been thoroughly investigated.
Objective: The primary objective of this study was to compare the effects of loading doses of rosuvastatin versus atorvastatin on immediate post-perfusion TIMI flow in patients undergoing primary PCI.
Methods: This prospective cohort study was conducted at Lahore Medical and Dental College, Lahore, Pakistan, from January 1, 2023, to December 31, 2023. A total of 246 patients undergoing primary PCI for ACS were enrolled and randomly assigned to receive either a loading dose of rosuvastatin (40 mg) or atorvastatin (80 mg). TIMI flow grade was assessed immediately post-perfusion using coronary angiography. Secondary outcomes included the incidence of major adverse cardiovascular events (MACE) within 30 days post-procedure. Data were analyzed using SPSS version 26.0, employing chi-square tests for categorical variables and Kaplan-Meier survival analysis for time-to-event data.
Results: The rosuvastatin group showed a significantly higher proportion of patients achieving TIMI grade 3 flow immediately post-PCI (74.8%) compared to the atorvastatin group (65.9%) (p = 0.04). No significant differences were observed between the two groups in terms of 30-day MACE rates (rosuvastatin: 7.3%, atorvastatin: 10.6%; p = 0.35).
Conclusion: The administration of a loading dose of rosuvastatin resulted in a higher rate of optimal coronary perfusion (TIMI grade 3 flow) immediately after PCI compared to atorvastatin. These findings suggest that rosuvastatin may be more effective in enhancing immediate coronary reperfusion, potentially improving clinical outcomes in ACS patients undergoing PCI.
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Syed Ikramullah
District Cardiologist at Cat-C Hospital Wari, Dir Upper, KPK, Pakistan.
Muhammad Ronuq Khan
Provincial Medical Officer and General Practitioner at Sehat Sahulat Program KPK and State Life Insurance Corporation of Pakistan
Minhal Javed
Medical Officer, Department of Medicine, Al-Mustafa Trust Hospital, Pakistan
Hamna Mehfooz
PGR, Internal Medicine, Mukhtar A Sheikh Hospital, Pakistan
Yusuf Yusuf
Foundation Year 2, Doctor, Department of Respiratory Medicine, Darlington Memorial Hospital
Noor Fatima
PGR, OBS & Gyne Department, Shaikh Zayed Hospital Lahore, Pakistan