Effect of High Dose Atorvastatin and Allopurinol Preloading on No-Reflow in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Abstract

Abstract Background No reflow is linked to worse prognosis post revascularization, so preventing no reflow is better than treating it. Objective this study aims to evaluate the effect of adding high-dose allopurinol and atorvastatin in preventing NRP when given before undergoing primary PCI in patients presenting with STEMI. Patients and Methods This study recruited 300 patients who were classified into 3 groups (100 each), Group A: patients were preloaded with high dose Allopurinol and Atorvastatin on top of the standard of care treatment according to the European society of cardiology guidelines. Group B: patients were preloaded with high dose Atorvastatin only on top of the standard of care treatment, Group C: were only preloaded with the standard care treatment according to the European society of cardiology guidelines, each group was subjected to the same pre procedural laboratory tests, primary percutaneous coronary intervention was done by the most experienced operator available according to the European society of cardiology guidelines. Results Percentage of post procedural no reflow was significantly lower in patients who were preloaded with high dose Allopurinol and Atorvastatin compared to the other 2 groups (highest with group C) (Group A: 11%, Group B: 23%, Group C: 39%). Conclusion preloading patients before primary percutaneous coronary intervention in patients presenting with ST elevation myocardial infarction with high dose Allopurinol and Atorvastatin significantly decreases incidence of post procedural no reflow.