Kamran Rashid, Irfan Majeed, Abdul Sattar, Nadeem Hayat Mallick.
Effect of Rosuvastatin on left ventricular remodeling in patients with elevated HS-C reactive protein after first ST segment elevation myocardial infarction (STEMI).
J Cardiovascular Dis Jan ;13(2):33-9.

OBJECTIVE: To assess the anti-inflammatory role of high dose Rosuvastatin therapy on post MI LV remodeling (LVR) in patients suffering from first ST segment elevation MI (STEMI). MATERIALS AND METHODS: The study was conducted at the Cardiology Department, Punjab Institute of Cardiology, Lahore which is a 347 bedded tertiary care hospital dedicated to cardiac patients only from January 2016 till July 2016 (6 months). Overall 120 patients presenting with first ST segment elevation MI, having Hs CRP level >3mg/l, were studied. These patients were divided into two groups on the basis of Rosuvastatin therapy, Group I: 60 patients having CRP levels >3mg/L received Rosuvastatin 20mg daily and Group II: 60 patients having CRP levels >3mg/L received Rosuvastatin 40mg daily. Patients were consented before start of the study. All patients underwent echocardiography for LV remodeling prior to discharge at 72 hours of admission and at 06 months follow-up. Occurrence of LVR on 6 months follow up was noted for every patient in the two groups. Any patient lost to follow-up was excluded. RESULTS: Mean age of patients in Group I was 57.4±12.6 years while it was 56.6±12.3 years for Group II patients with non significant association. The proportion of males and females was similar in the two groups as there were 42(71.7%) males and 17(28.3%) females in Group I and there were 45(75%) males and 15(25%) females in Group II (p value 0.8415). There were more smokers 25(41.6%) in Group I as compared to 22(36.7%) Group II (p value 0.708). Diabetes mellitus was observed in similar proportions in the two groups as there were 21(35%) diabetics in Group II vs. 20(33.3%) in Group I (p value 1.00). Hypertension was present in 29(48.3%) in Group II and 28(46.6%) in Group I (p value 1.00). History of coronary artery disease was present in 22(36.7%) in Group II and it was 20(33.3%) in Group I (p value 0.841). Family history of coronary artery disease was 20(33.2%) in Group II and it was 19(31.6%) in Group I (p value 1.00). Dyslipidemia was 21(35%) in Group II and 20(33.3%) in Group I (p value 1.00). Stress was present in 9(15%) in Group II and 7(11.7%) in Group I. Echocardiography done during admission revealed mean left ventricular end-diastolic volume (LVEDV) of 119.2±29.3 ml in Group I and it was 118.6±31.4 ml in Group II (p value 0.941). Mean left ventricular endsystolic volume (LVESV) was 67.1±22.4 ml in Group I and 69.5±24.3 ml in Group II (p value 0.8744). Mean ejection fraction was 42.3±6.3 for Group I and 41.5±8.4 for Group II (p value 0.96). Mean S’ was similar in the two groups. E/E and E/E’ ratios were similar in the two groups with non significant association. Mean Left ventricular mass was 143.2±36.2 gm in Group I and 142.4±33.6 gm in Group II. Mean Wall motion score Index was also similar in both groups. 06(10%) patients died in group 1 during hospital stay and 05 (8.3%) patients died in group II (p value 1.00). LVEDV increased from 119.2±29.3 to 122.4±26.3 (p value 0.049) in group I, while in group II LVEDV increased from 118.6±31.4 to 120.3±28.3 (p value 0.053).

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