Beneficial effects of statin treatment on coronary microvascular dysfunction and left ventricular remodeling in patients with acute myocardial infarction

Background: Statin treatment has been shown to improve coronary endothelial function, irrespective of lipid-lowering effects. This study's aim was to elucidate the effects of statin treatment on coronary microvascular dysfunction and left ventricular remodeling in acute myocardial infarction (AMI) patients. Methods: Thirty-five patients undergoing successful reperfusion following AMI were assigned to a statin-treated (Group S, 16) or a non-statin-treated (Group NS, 19) group, according to fasting serum low-density lipoprotein-cholesterol. N-13-ammonia positron emission tomography was performed to assess myocardial flow reserve (MFR) in the infarct area. Results: Infarct sizes and lipid profiles during the chronic period were similar between the two groups. At 2 weeks after AMI onset, mean MFR in the infarct area was significantly higher in Group S than in Group NS (2.34 +/- 0.63 vs. 1.91 +/- 0.43, p=0.0214). At 6 months post-AMI, Group S had a smaller left-ventricular end-diastolic volume index (69.4 +/- 11.7 mL/m(2) vs. 88.5 +/- 32.5 mL/m(2), p=0.0328) and higher left-ventricular ejection fraction (67.7 +/- 9.2% vs. 59.2 +/- 13.3%, p=0.0394) than Group NS. Serum asymmetric dimethylarginine was significantly increased in Group NS at 1 month post-AMI (0.43 +/- 0.12 mu mol/L (baseline) vs. 0.52 +/- 0.14 mu mol/L, p=0.0186), but unchanged in Group S. Conclusions: Statin treatment appears to beneficially attenuate left ventricular remodeling after AMI, which may be associated with restoring coronary endothelial function via endogenous nitric oxide. (C) 2011 Elsevier Ireland Ltd. All rights reserved.