Effect of high versus low Rosuvastatin therapy on 12-week mortality and Left Ventricular Cardiac Function in Patients Suffering from first ST segment elevation MI

• AMEER HAMZA

  Shaikha Fatima Institute of Nursing and Health Sciences (SFINHS), Shaikh Zayed Medical Complex, Lahore.

  Author

• ANEELA SHAHZADI

  Department of Neuromuscular, University of biological and sciences, Lahore

  Author

• MUHAMMAD TAHA

  Shaikha Fatima Institute of Nursing and Health Sciences (SFINHS), Shaikh Zayed Medical Complex, Lahore.

  Author

• NOUMAN ANAYAT

  Department of medicine, Shaikh Zayed Medical Complex, Lahore

  Author

Abstract

Background: STEMI is a life-threatening condition resulting from acute occlusion of a coronary artery, leading to myocardial ischemia and necrosis. The pathophysiology involves the rupture of an atherosclerotic plaque and subsequent thrombus formation, predominantly affecting the left anterior descending (LAD), right coronary (RCA), or left circumflex (LCx) arteries. The extent of myocardial damage influences post-infarction complications, including left ventricular (LV) remodelling, a key determinant of long-term prognosis. ¹

Objective: To compare the efficacy of high- versus low-dose statin therapy on mortality and morbidity at baseline and at 12-week follow-up in patients suffering from first STEMI.

Methodology: Study included 110 patients presenting with their first ST-segment elevation myocardial infarction (STEMI), aged 25 years or older. The sample size of 110 (55 patients per group) was calculated using the WHO sample size calculator, applying the population proportion formula with a 5% significance level and 95% study power. Patients receiving rosuvastatin 40 mg (Group I) and rosuvastatin 20 mg (Group II).

Results: High-dose rosuvastatin (40 mg) showed greater improvements in cholesterol levels, inflammation, and liver function compared to the low dose (20 mg) over 12 weeks. It significantly lowered triglycerides (33.1%) vs. 11%), total cholesterol (25% vs. 20%), LDL-C (24.7% vs. 13.6%), and CRP (71.5% vs. 59.3%) while increasing HDL-C (20.2% vs. 10.8%) more effectively. Liver enzyme levels improved in both groups, and kidney function remained stable. High-dose rosuvastatin significantly improved echocardiographic parameters compared to the low dose over 12 weeks. Left ventricular end-systolic and end-diastolic dimensions (LVESD, LVEDD) and volumes (LVESV, LVEDV) decreased more in the high-dose group (p<0.05), indicating better cardiac remodeling. Left ventricular ejection fraction (LVEF) improved significantly with high-dose treatment (58.29% vs. 53.96%, p=0.001), suggesting enhanced heart function.

Conclusion: Key words ST-segment elevation myocardial infarction (STEMI), left anterior descending (LAD), right coronary arteries (RCA), left circumflex arteries (LCx), left ventricular (LV), C-reactive protein (hs-CRP), left ventricular remodeling (LVR), Percutaneous Coronary Intervention (PCI), electrocardiogram (ECG).

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Copyright (c) 2025 AMEER HAMZA, ANEELA SHAHZADI, MUHAMMAD TAHA, NOUMAN ANAYAT (Author)

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