ABSTRACT
The purpose of the study was to investigate whether early high-dose potent statin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention can reduce infarct size compared with conventional low-dose statin therapy. In a randomized placebo-controlled multicenter trial, 185 patients were assigned either to an early high-dose rosuvastatin group (n = 92, rosuvastatin 40 mg before treatment plus maintenance for 7 days) or to a conventional low-dose rosuvastatin group (n = 93, placebo before treatment plus rosuvastatin 10-mg maintenance for 7 days). Serial cardiac magnetic resonance imaging (MRI) was performed during the acute (3 to 7 days) and chronic (3 months) phases. The primary end point was relative infarct volume assessed by MRI at 3 months. Baseline characteristics were similar between the 2 groups, except hypertension, which was more prevalent in the high-dose group. Serial MRI data were available for 121 patients (high-dose group n = 54 and low-dose group n = 67). The relative infarct volumes in the acute (23.0 ± 9.5% vs 20.5 ± 11.7%, p = 0.208) and chronic (15.9 ± 8.3% vs 15.8 ± 9.7%, p = 0.943) phases were not different between the groups. No differences between groups were observed for periprocedural microvascular circulation evaluated by Thrombolysis In Myocardial Infarction flow grade, myocardial blush grade, ST-segment resolution, microvascular obstruction on cardiac MRI, or clinical outcomes. In conclusion, early high-dose rosuvastatin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention did not improve periprocedural myocardial perfusion or reduce infarct volume measured by MRI compared with the conventional low-dose rosuvastatin regimen.
Subject(s)
Fluorobenzenes/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Myocardial Infarction/drug therapy , Myocardial Infarction/surgery , Percutaneous Coronary Intervention , Pyrimidines/administration & dosage , Sulfonamides/administration & dosage , Anticoagulants/administration & dosage , Combined Modality Therapy , Double-Blind Method , Drug-Eluting Stents , Electrocardiography , Female , Humans , Hypertension/physiopathology , Magnetic Resonance Imaging , Male , Middle Aged , Myocardial Infarction/physiopathology , Placebos , Prospective Studies , Republic of Korea , Rosuvastatin Calcium , Secondary Prevention , Treatment OutcomeABSTRACT
The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n = 28), the placebo group (n = 28), and the no-treatment control group (n = 27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F = 6.71, P = 0.002) between groups after intervention. There was also a significant difference in SBP (F = 13.34, P = 0.001) and diastolic blood pressure (DBP) (F = 8.46, P = 0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F = 6.75, P = 0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life.
ABSTRACT
BACKGROUND: Atorvastatin pretreatment has been reported to reduce myocardial damage in patients undergoing percutaneous coronary intervention (PCI). We sought to investigate the effect of atorvastatin pretreatment on infarct size in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Patients undergoing primary PCI for ST-segment elevation myocardial infarction within 12 hours after symptom onset were randomized to an atorvastatin group (80 mg before PCI and for 5 days after PCI [n = 89]) or a control group (10 mg daily after PCI [n = 84]). The primary end point was infarct size measured by technetium Tc 99m tetrofosmin single-photon emission computed tomography between days 5 and 14. RESULTS: Baseline clinical, angiographic, and procedural characteristics were not significantly different between groups except for age and current smoking status. There was no significant difference in infarct size (as a percentage of the left ventricle) between groups (22.2% ± 15.5% in the atorvastatin group vs 21.6% ± 15.4% in the control group, P = .79). The median infarct size was 19.0% (interquartile range 9.0-32.0) in the atorvastatin group and 18.0% (9.3-32.5) in the control group (P = .76). Achievement of myocardial blush grade 2/3 and complete ST-segment resolution at 60 minutes after PCI occurred with similar frequency (72.8% vs 81.9%, P = .33 and 43.2% vs 47.5%, P = .57, respectively). CONCLUSIONS: Pretreatment with high-dose atorvastatin followed by further treatment for 5 days did not reduce infarct size measured by single-photon emission computed tomography in patients undergoing primary PCI.