Efficacy of Early Intensive Rosuvastatin Therapy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (ROSEMARY Study)

Ko, Young Guk; Won, Hoyoun; Shin, Dong Ho; Kim, Jung Sun; Kim, Byeong Keuk; Choi, Donghoon; Hong, Myeong Ki; Bae, Jang Ho; Lee, Sahng; Lim, Do Sun; Jang, Yangsoo

doi:10.1016/j.amjcard.2014.03.059

Cited by 19 publications

(28 citation statements)

References 26 publications

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“…There were ten trials [ 8 , 10 , 11 , 13 , 15 , 17 – 21 ] with only statin naïve patients, one trial [ 16 ] with only previous statin therapy patients, and three trials [ 9 , 12 , 14 ] with both of two. Five trials [ 9 , 14 – 16 , 21 ] included stable angina patients, six trials [ 8 , 11 , 13 , 17 , 19 , 20 ] included NSTE-ACS patients, two trials [ 12 , 18 ] included STEMI patients, and one trial [ 10 ] included ACS patients. Thirteen trials [ 8 – 13 , 15 – 21 ] included short-term RSV pretreatment (immediate to 24 h), while one trial [ 14 ] included relatively long-term RSV pretreatment (5 to 7 days).…”

Section: Resultsmentioning

confidence: 99%

“…Approximately two-thirds of the overall population were male, three-fifths of those had hypertension, and one-third of those had diabetes. Preprocedural aspirin and clopidogrel were given to patients in all studies, and patients among four trials [ 11 , 12 , 15 , 16 ] received a loading dose of clopidogrel (600 mg), while the number of patients treated with clopidogrel in one trial [ 10 ] were unclear. Patients in a total of 11 trials [ 8 , 11 – 13 , 15 – 21 ] received glycoprotein IIb/IIIa inhibitors (GPIs) at the operators’ discretion, while the remaining trials [ 9 , 10 , 14 ] did not mention the use of GPIs.…”

Section: Resultsmentioning

confidence: 99%

“…2 . Five of fourteen trials [ 10 , 12 , 15 , 16 , 19 ] reported the specific methods used for randomization, while the remaining included trials [ 8 , 9 , 11 , 13 , 14 , 17 , 18 , 20 , 21 ] did not mention that. Three trials [ 10 , 12 , 15 ] described the allocation concealments in detail, two trials [ 11 , 14 ] did not use allocation concealments, and allocation concealments were not described in the remaining trials.…”

Section: Resultsmentioning

confidence: 99%

“…Five of fourteen trials [ 10 , 12 , 15 , 16 , 19 ] reported the specific methods used for randomization, while the remaining included trials [ 8 , 9 , 11 , 13 , 14 , 17 , 18 , 20 , 21 ] did not mention that. Three trials [ 10 , 12 , 15 ] described the allocation concealments in detail, two trials [ 11 , 14 ] did not use allocation concealments, and allocation concealments were not described in the remaining trials. [ 8 , 9 , 13 , 16 – 21 ] Blinded methods were used in four trials, three of which [ 10 , 12 , 13 ] used a blinded approach for investigators, participants and outcome assessors, while one trial [ 17 ] was only blinded for outcome assessors.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials

Pan

Tan

et al. 2015

Lipids Health Dis

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BackgroundNumerous studies have evidenced that statins can reduce the incidence of cardiovascular disease. However, the effects of high-dose rosuvastatin (RSV) preloading in patients undergoing percutaneous coronary intervention (PCI) are controversial.ObjectiveWe attempted to identify and quantify the potential cardioprotective benefits of high-dose RSV preloading on final thrombolysis in myocardial infarction (TIMI) flow grade, major adverse cardiac events (MACE), and peri-procedural myocardial injury (PMI) in patients undergoing PCI.MethodsPubmed, EMBASE, Cochrane Central Register of Controlled Trials and ISI Web of Science databases were systematically searched for randomized controlled trials (RCTs) up to June 2015. We assessed the incidence of MACE and PMI in all enrolled patients for subgroups stratified by clinical presentation and previous statin therapy during the follow-up period.ResultsFourteen trials with 3368 individuals were included in our meta-analysis. High-dose RSV preloading before PCI lead to a 58 % reduction in MACE (odds ratio [OR] = 0.42, 95 % confidence intervals [CI]: 0.29-0.61, P < 0.00001) and a 60 % reduction in PMI (OR = 0.40, 95 % CI: 0.25–0.63, P < 0.0001). This procedure also improved the final TIMI flow grade in patients undergoing PCI (OR = 1.61, 95 % CI: 1.09–2.38, P = 0.02). The benefits on MACE were significant for both stable angina patients (OR = 0.42, 95 % CI: 0.21-0.87, P = 0.02) and acute coronary syndrome (ACS) patients (OR = 0.42, 95 % CI: 0.27-0.65, P < 0.0001); and for both statin naïve patients (OR = 0.42, 95 % CI: 0.28-0.64, P < 0.0001) and previous statin therapy patients (OR = 0.28, 95 % CI: 0.10-0.73, P = 0.01).ConclusionHigh-dose RSV preloading can significantly improve myocardial perfusion and reduce both MACE and PMI in patients undergoing PCI. The cardioprotective benefits of RSV preloading were significant in not only stable angina and ACS patients but also statin naïve and previous statin therapy patients. The cardioprotective benefits of RSV preloading in the follow-up period mainly resulted from a reduction in spontaneous MI and TVR, especially for ACS and statin naïve patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials

Pan

Tan

et al. 2015

Lipids Health Dis

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“…Another study compared 40 mg rosuvastatin versus placebo as a loading dose before PCI and daily maintenance doses for following 7 days. However, it did not show significant differences in periprocedural coronary flow, infarct burden on cardiac magnetic resonance imaging, or clinical outcomes (17). Considering our clinical experiences and available evidences, we have an insight that initiation of high intensity statin at earlier time during in-hospital management is mostly feasible (even in the setting of urgent or emergency PCI) and not associated with increasing adverse events at worst.…”

Section: Editorialmentioning

confidence: 79%

Timing of high intensity statin for acute coronary syndrome: how earlier initiation makes better?

Kim

Choi

2018

J. Thorac. Dis.

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Statin-Induced Cardioprotection Against Ischemia-Reperfusion Injury: Potential Drug-Drug Interactions. Lesson to be Learnt by Translating Results from Animal Models to the Clinical Settings

Birnbaum

et al. 2015

Cardiovasc Drugs Ther

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Numerous interventions have been shown to limit myocardial infarct size in animal models; however, most of these interventions have failed to have a significant effect in clinical trials. One potential explanation for the lack of efficacy in the clinical setting is that in bench models, a single intervention is studied without the background of other interventions or modalities. This is in contrast to the clinical setting in which new medications are added to the "standard of care" treatment that by now includes a growing number of medications. Drug-drug interaction may lead to alteration, dampening, augmenting or masking the effects of the intended intervention. We use the well described model of statin-induced myocardial protection to demonstrate potential interactions with agents which are commonly concomitantly used in patients with stable coronary artery disease and/or acute coronary syndromes. These interactions could potentially explain the reduced efficacy of statins in the clinical trials compared to the animal models. In particular, caffeine and aspirin could attenuate the infarct size limiting effects of statins; morphine could delay the onset of protection or mask the protective effect in patients with ST elevation myocardial infarction, whereas other anti-platelet agents (dipyridamole, cilostazol and ticagrelor) may augment (or mask) the effect due to their favorable effects on adenosine cell reuptake and intracellular cAMP levels. We recommend that after characterizing the effects of new modalities in single intervention bench research, studies should be repeated in the background of standard-of-care medications to assure that the magnitude of the effect is not altered before proceeding with clinical trials.

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Efficacy of Early Intensive Rosuvastatin Therapy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (ROSEMARY Study)

Cited by 19 publications

References 26 publications

Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials

Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials

Timing of high intensity statin for acute coronary syndrome: how earlier initiation makes better?

Statin-Induced Cardioprotection Against Ischemia-Reperfusion Injury: Potential Drug-Drug Interactions. Lesson to be Learnt by Translating Results from Animal Models to the Clinical Settings

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