Comparative Effects of Rosuvastatin and Atorvastatin Loading Doses on Immediate Post-percutaneous Coronary Intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) Flow in ST-Segment Elevation Myocardial Infarction (STEMI) Patients

Cureus. 2024 Nov 20;16(11):e74076. doi: 10.7759/cureus.74076. eCollection 2024 Nov.

Abstract

Background: Primary percutaneous coronary intervention (PCI) is crucial in managing acute ST-segment elevation myocardial infarction (STEMI), emphasizing the importance of optimal myocardial reperfusion.

Objective: The goal of this research was to determine how loading doses of rosuvastatin and atorvastatin affected the flow rate of thrombolysis in myocardial infarction (TIMI) immediately post-perfusion thrombolysis in patients undergoing primary PCI.

Methodology: This prospective, comparative study was carried out over a one-year period (January 2023 to December 2023) in Pakistan. Data was gathered from patient interviews and electronic medical records for adult patients receiving primary PCI. Interventional cardiologists who were blinded to the evaluation of the immediate post-perfusion TIMI flow conducted statistical analysis to compare the results between the two statin groups.

Results: Both groups had good procedural success rates: 184 patients (92.00%) in the group using rosuvastatin and 179 patients (89.50%) in the group on atorvastatin (p = 0.284). A comparable use of auxiliary equipment was seen, with 103 patients (51.50%) and 97 patients (48.50%) in the atorvastatin group and 108 patients (54.00%) and 92 patients (46.00%) in the rosuvastatin group, respectively (p = 0.53). There were no notable variations in the immediate post-perfusion TIMI flow grades either, with p-values of 0.532 for normal flow and 0.421 for no-reflow. The two groups' mean lengths of hospital stays were comparable, measuring 3.5 days (± 1.2) for the rosuvastatin group and 3.8 days (± 1.3) for the atorvastatin group (p = 0.321).

Conclusion: Rosuvastatin and atorvastatin had comparable rapid post-perfusion TIMI flows in the initial PCI participants, indicating that they may be used interchangeably to maximize myocardial reperfusion in acute STEMI.

Keywords: atorvastatin; cardiovascular outcomes; myocardial reperfusion; pci; rosuvastatin; stemi.