Intensive Statin Treatment for STEMI Patients Undergoing Primary PCI

ARMYDA-ACS, ARMYDA-RECAPTURE and NAPLES II demonstrated that in patients with ASP and NSTE ACS undergoing early PCI, loading dose of atorvastatin before early PCI led to a reduction of prei-PCI MI, recurrent CV events and mortality. While, theses studies included patients with non-ST-segment elevation ACS, requiring PCI; these results cannot be extrapolated directly to patients with ST-segment elevation MI, and these trials included patients sent to an early and selective PCI, but not those undergoing emergency revascularization;

This study is designed to find out whether STEMI patients undergoing emergency PCI can benefit from intensive atorvastatin treatment compared with routine treatment.

• Drug: atorvastatin
  80mg atorvastatin immediately after enrollment, emergency PCI,atorvastatin 40mg/d and other usual medication after PCI
  Other Name: Lipitor
• Drug: atorvastatin
  No loading dose of statin after enrollment, emergency PCI, atorvastatin 20mg/d and other usual medication after PCI
  Other Name: Lipitor

• Active Comparator: usual care
  Intervention: Drug: atorvastatin
• Experimental: intensive statin treatment
  Intervention: Drug: atorvastatin

Inclusion Criteria:

• 20-75 years old
• myocardiac ischemia symptom of index event appeared less than 12 hours before enrollment.
• ECG showed elevated ST segment in 3 or more contiguous leads
• diagnosed with acute STEMI
• eligible for primary PCI, and primary PCI is scheduled within 2 hours after enrollment

Exclusion Criteria:

• allergic or experienced serious adverse reaction to HMG-CoA reductase
• pregnancy, lactation, or child bearing potential women without any effective contraception
• accompanied with malignant disease
• active hepatic disease or hepatic dysfunction