HIGH-DOSE STATIN PRIOR TO PRIMARY PERCUTANEOUS CORONARY INTERVENTION REDUCES OXIDATIVE STRESS BURDEN IN PATIENTS WITH ACUTE ST-ELEVATION MYOCARDIAL INFARCTION

The current study analysed the effect of high-dose statin loading prior to primary percutaneous coronary intervention on oxidative stress markers, in patients with acute ST-elevation myocardial infarction (STEMI). Besides the lipid lowering effect, statins have antioxidant properties that might reduce myocardial ischemia-reperfusion injury. From a total of 37 patients, 18 patients received high-dose statin before coronarography and were included in the statin group, while 19 statin naive patients were included in the control group. Peripheral venous blood samples were obtained before coronary reperfusion, at 1 hour and 24 hours after that. The following markers of oxidative stress were determined from the serum: malondialdehyde (MDA), reduced glutathione to oxidized glutathione ratio (GSH/GSSG) and total antioxidant capacity (TAC). Values are shown as medians and interquartile ranges. MDA concentration and TAC had non-significant differences between the two groups, at all time frames. Before angioplasty, GSH/GSSG ratio was comparable between the two groups: 3.59 (2.13-5.37) in the statin group vs 2.69 (2.15-5.02) in the control group, p=0.49. At 1 hour after reperfusion, values were still similar: 2.26 (1.32-4.28) in the statin group vs 2.33 (1.88-2.50) in the control group, p=0.55. After 24 hours, there was a significant increase of GSH/GSSG ratio in the statin group 2.41 (1.58-3.28) vs 1.56 (1.12-2.03) in the control group, p=0.01. This finding suggest that, in STEMI patients, high-dose statin loading before primary percutaneous coronary intervention significantly reduces oxidative stress burden, early after administration.