Chronic statin treatment is a predictor of pre-interventional infarct-related artery patency in patients with ST elevation myocardial infarction treated with percutaneous coronary intervention

   Background: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct-related artery (IRA) patency before percutaneous coronary intervention (PCI) is known to be a strong pre­dictor of improved clinical outcome. Aim: We aimed to investigate the effects of chronic statin treatment before admission on IRA patency after myocardial infarction. Methods: In this study, 938 ST elevation myocardial infarction (STEMI) patients admitted to the hospital within the first 12 h of symptom onset were prospectively enrolled (male, n = 682; female, n = 256; mean age 58.6 ± 12.4 years). All patients underwent emergent primary PCI. Patients were divided into two groups based upon angiographic IRA patency. Impaired IRA patency was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 0 and 1 flow (non-patent IRA group). Angiographic IRA patency was defined as TIMI 2 and 3 flow (patent IRA group). Results: Previous statin usage was more frequent in the patent IRA group (n = 138; 71.9%), than in the non-patent IRA group (n = 110; 14.7%; p < 0.001). Pre-PCI IRA patency was independently associated with body mass index (odds ra­tio [OR] = 1.087, 95% confidence interval [CI] 1.005–1.176, p < 0.001), previous chronic statin use (OR 0.065, 95% CI 0.043–0.098, p = 0.039), ejection fraction (OR 1.041, 95% CI 1.018–1.064, p < 0.001), and SYNTAX score (OR 0.927, 95% CI 0.899–0.957, p < 0.001) in multivariate logistic regression analysis. Conclusions: Chronic pre-treatment with statins is a significant predictor of the IRA patency in patients with STEMI

Uric acid and high sensitive C-reactive protein are associated with subclinical thoracic aortic atherosclerosis

AbstractBackground and purposeThe detection of atherosclerotic lesions in the aorta by transesophageal echocardiography (TEE) is a marker of diffuse atherosclerotic disease. Hyperuricemia is a well-recognized risk factor for cardiovascular diseases. However, no data are available concerning the relationship between serum uric acid (UA) and subclinical thoracic aortic atherosclerosis. We aimed to investigate the association between thoracic aortic atherosclerosis and serum UA level.MethodsWe studied 181 patients (mean age 46.3±8 years) who underwent TEE for various indications. Four different grades were determined according to intima–media thickness (IMT) of thoracic aorta. UA and other biochemical markers were measured with an automated chemistry analyzer.ResultsTEE evaluation characterized thoracic aortic intimal morphology as Grade 1 in 69 patients, Grade 2 in 52 patients, Grade 3 in 31 patients, and Grade 4 in 29 patients. The highest UA level was observed in patients with Grade 4 IMT when compared with Grade 1 and 2 IMT groups (p<0.001 and p=0.014, respectively). UA levels in patients with Grade 3 and Grade 2 IMT were also higher than patients with Grade 1 IMT group (p<0.001, for all). In multiple linear regression analysis, IMT was independently associated with UA level (β=0.350, p<0.001), age (β=0.219, p=0.001), total cholesterol (β=−0.212, p=0.031), low-density lipoprotein cholesterol (β=0.350, p=0.001), and high sensitivity C-reactive protein (hsCRP) levels (β=0.148, p=0.014).ConclusionUric acid and hsCRP levels are independently and positively associated with subclinical thoracic atherosclerosis