P395Fluctuate in distribution of lipoprotein particle size during the early statin therapy after primary percutaneous coronary intervention for myocardial infarction with ST-segment elevation

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Abstract

Purpose

It has been reported that most of the patients presenting myocardial infarction would not be eligible for intensive lipid-lowering therapy, although early statin therapy has been reported associated with better clinical outcomes. However, detailed lipid profile in acute phase of ST-segment elevation myocardial infarction (STEMI) is not fully understood. Therefore, we evaluated the distribution of lipoprotein size in acute phase of STEMI with statin therapy.

Methods

Consecutive 27 patients (67 ± 10 year-old) with STEMI within 12 hours after onset who had no history of statin therapy were enrolled in this study. Atrovastatin 10mg daily or rosuvastatin 5mg daily was prescribed from hospital admission. Lipid profiles were analyzed by polyacrylamide gel electrophoresis (PAGE) at hospital admission and at hospital discharge.

Results

Serum low-density lipoprotein cholesterol (LDL-C) level significantly decreased from hospital admission to hospital discharge (101 ± 11 mg/dl to 67 ± 25 mg/dl, p < 0.01). PAGE detected small dense LDL at hospital admission in 67% (18/27) and it decreased in 22% (6/27) at hospital discharge. In contrast, intermediate density lipoprotein (IDL) was detected in 33% (9/27) at hospital admission and it increased in 81% (22/27) at hospital discharge.

Conclusions

The distribution of lipoprotein particle size fluctuated during the early statin therapy. Small dense LDL was detected in 67% at hospital admission and IDL was detected in 81% at hospital discharge, indicating still inadequate early statin therapy in patients with STEMI despite normal range of serum LDL-C level.

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