Abstract 15027: Previous Therapy with Statins Reduces the Inflammatory Response in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Background: Statins are known to possess anti-inflammatory properties in addition to their lipid lowering activity. Several inflammatory biomarkers including leukocyte (WBC) and neutrophil (Neutro) count and neutrophil to lymphocyte ratio (NLR) have been suggested as prognostic markers in patients with ST-elevation myocardial infarction (STEMI). Aim: Goal of this study was to investigate whether a previous therapy with statins influenced the inflammatory response of patients with STEMI. Methods: Consecutive patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI in our Department from 2006 to 2012 (n=1271) were evaluated. We compared patients on statins at the time of STEMI (103; 8,1%) with the others. Inflammatory indexes were obtained by blood samples collected at hospital admission (T0) and the following day (T1). Results: Patients with previous statin-therapy were older (65 ± 12 vs 62 ± 13 years , p=0.007), had more frequently a previous MI (55% vs 8%, p<0.001), hypertension (66% vs 52%, p=0.002), dyslipidemia (75% vs 35% p<0.001), diabetes (25% vs 14%, p=0.002) and familiarity for cardiovascular diseases (44% vs 39%, p=0.01). They also showed a lower LV ejection fraction after PCI (42 ± 10% vs 45 ± 10% p=0.01) The inflammatory response in the two groups is shown in the Table. Previous statin-therapy was an independent predictor of all inflammatory markers at multivariable analysis. Conclusions: Previous statin-therapy at the time of STEMI reduces the inflammatory response, an effect associated with a better prognosis. Thus, treatment with statins in patients at risk not only reduces the incidence of MI but is likely to improve prognosis if a STEMI does occur.