TCT-1197 High-Dose Statin Preloading in Acute Coronary Syndrome Patients Prior to PCI: Impact on Long-Term Clinical Outcomes

Document Type

Abstract

Publication Date

10-28-2025

Abstract

Background: High-dose statin therapy prior to percutaneous coronary intervention (PCI) has been hypothesized to reduce periprocedural myocardial injury and improve long-term outcomes in acute coronary syndrome (ACS) patients. This study evaluates the effectiveness of statin preloading in the emergency room (ER) before coronary angiography and PCI versus no statin preloading on long-term cardiovascular outcomes. Methods: We conducted a pooled meta-analysis of randomized controlled trials and large-scale observational studies involving ACS patients undergoing PCI. A total of 8,912 patients were included: 4,431 received high-dose statin therapy (atorvastatin 80 mg or rosuvastatin 40 mg) in the ER prior to PCI, and 4,481 did not receive statin preloading. The primary endpoint was the incidence of major adverse cardiovascular events (MACE) at 12 months. Secondary endpoints included all-cause mortality, non-fatal myocardial infarction (MI), stent thrombosis, and target lesion revascularization (TLR). Patient demographics were balanced between groups. Results: Statin preload was associated with a significant reduction in 12-month MACE (10.2% vs 13.9%, p=0.002), all-cause mortality (2.6% vs 4.1%, p=0.01), non-fatal MI (3.9% vs 5.5%, p=0.02), stent thrombosis (0.7% vs 1.5%, p=0.03), and TLR (5.1% vs 6.8%, p=0.04). Baseline characteristics including age (mean 61.8 vs 62.1 years, p=0.32), gender, diabetes, hypertension, and LDL-C were statistically similar across groups. Conclusion: High-dose statin administration in the ER prior to PCI in ACS patients significantly improves long-term cardiovascular outcomes, including reductions in MACE, mortality, and stent-related complications. These findings support guideline-recommended statin preloading as a routine component of early ACS management. Categories: CORONARY: Pharmacology/Pharmacotherapy

Publication Title

Journal of the American College of Cardiology

Volume

86

Issue

17 Supplement

First Page

B512

Last Page

B512

Comments

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