Early atorvastatin therapy improves cardiac function in patients with acute myocardial infarction

Abstract

Background: A number of experimental and clinical studies have demonstrated a cardioprotective effect of statins; however, the effect of atorvastatin on cardiac function in patients with an acute myocardial infarction (AMI) has not been established.

Methods and results: Thirty consecutive patients with an AMI (16 males and 14 females) were enrolled. All the patients underwent successful percutaneous coronary intervention in the early phase after the onset of an AMI. Patients with a total cholesterol level > 200mg/dL on admission (n = 14) were assigned to the atorvastatin group. They began taking 10 mg of atorvastatin daily within 48 h after the onset of the AMI, while the other patients (n = 16) did not receive atorvastatin and served as the control group. Echocardiography and blood sampling to measure brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) levels were repeated on the 2nd day (2D), 3 weeks (3W), 12 weeks (12W), and 24 weeks (24W) after the onset of the AMI. The percentage of patients with a high BNP level (BNP > 20 pg/mL) was significantly decreased from 2D to 24W in the atorvastatin group, but not in the control group (100 to 57% in the atorvastatin group, p < 0.05; 100 to 80% in the control group, n.s.). Similar results also occurred with respect to the ANP level (ANP > 40 pg/mL) (62 to 21% in the atorvastatin group, p < 0.05; 57 to 40% in the control group, n.s.). The left ventricular ejection fraction was significantly higher in the atorvastatin group than the control group at 3W (66.0 ± 7.8% vs. 56.5 ± 11.8%, p < 0.05) and 24W (67.5 ± 9.2% vs. 59.7 ± 9.8%, p < 0.05). In the atorvastatin group, the left ventricular systolic diameter was significantly decreased at 24W compared with that at 2D (37.1 ± 8.0 mm to 31.4 ± 6.5 mm, p < 0.05).

Conclusions: Initiation of atorvastatin in the early phase of an AMI has beneficial effects on cardiac function, probably by improving left ventricular remodeling.