Evaluating the benefits of high-dose statin preloading in ST-segment elevation myocardial infarction management: insights from a systematic review and meta-analysis.

Coron Artery DisMar 9, 2026 (epub)
Clinical ResearchCardiology

Bernardo Resende, Emídio Mata, Tomás Carlos et al.

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In 30 seconds

This systematic review and meta-analysis assessed high-dose statin preloading before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). It included nine randomised controlled trials with 1862 patients, comparing preloading with placebo or no statin. Preloading was associated with greater odds of post-PCI TIMI flow grade 3 (OR: 1.52, 95% CI: 1.06-2.20) and lower odds of all-cause mortality (OR: 0.59, 95% CI: 0.36-0.98). The analysis found no significant difference in achieving at least 50% ST-segment resolution.

Key findings

  • High-dose statin preloading increased the likelihood of post-PCI TIMI flow grade 3 (OR: 1.52, 95% CI: 1.06-2.20).
  • Preloading was associated with lower all-cause mortality (OR: 0.59, 95% CI: 0.36-0.98).
  • There was no significant difference in at least 50% ST-segment resolution (OR: 1.04, 95% CI: 0.71-1.50).

Why it matters

The findings suggest that statin loading before primary PCI may be associated with better angiographic reperfusion and lower mortality in STEMI. The absence of a significant difference in ST-segment resolution indicates that the observed benefits were not consistent across reperfusion measures. These pooled trial results provide evidence relevant to ongoing consideration of pre-PCI statin use.

Source

PubMed · PMID 41797499

Published in Coron Artery Dis. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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