Effect Of Oral Atorvastation On Inflammatory Factor In The Infarct-related Coronary Artery In Patients With ST-segment Elevated Myocardial Infarction Prior To Primary Percutaneous Coronary Intervention

Objective:Our objective was to explore the effects of atorvastatin on changes of CD4+CD25+ regulatory T cells (Tregs), FoxP3 expression, monocyte chemoattractant protein-1 (MCP-1) and macrophage migration inhibitory factor (MIF) in the infarct-related coronary artery (ICA) and peripheral veinous blood and prognosis of patients with ST-segment elevation myocardial infarction (STEMI).Methods:We recorded 112 cases of patients with STEMI who were randomly assigned to receive either atorvastatin 80 mg (n=52), or placebo (n=60) prior to primary PCI (percutaneous coronary intervention). Blood samples were obtained from the ICA and peripheral vein during PCI. The proportion of CD4+CD25+ Tregs, FoxP3 mRNA expression in blood, and concentrations of MCP-1, MIF,transforming growth factor-β(TGF-β) and interferon-γ(IFN-γ) in plasma of the samples were measured or detected by flow cytometry, real-time PCR, or enzyme-linked immunosorbent assay, respectively. And the prognosis of all patients in three months after PCI were analyzed.Results:1. In comparison with the control group, the proportions of CD4+CD25+ Tregs and the mRNA level of FoxP3 and TGF-βsignificantly increased, however MCP-1 and IFN-γdecreased with atorvastatin therapy, with no changes in level of MIF. 2. In the controls, the proportions of CD4+CD25+ Tregs and the mRNA level of FoxP3 and TGF-βwere significantly decreased, but the level of MCP-1, MIF and IFN-γincreased more in the ICA than in the peripheral vein.Conclusion:1.The inhibition of CD4+CD25+ Tregs in STEMI patients could be regulated with atorvastation given before PCI.2.Oral administration of atorvastatin in patients with STEMI before PCI could decrease the levels of inflammatory factors and improve the prognosis of STEMI patients.