Utjecaj visoke doze statina primijenjene u prva 24 sata nakon akutnoga koronarnoga sindroma na kliničke ishode i reaktivnost trombocita

Aim of this study is to ascertain if administering statins within 24 h from the onset of ACS influences survival and if the interaction of DAPT with ticagrelor and aspirin combined with atorvastatin 80 mg influences platelet reactivity (PR). Hypothesis of this study is that administration of high dose statins within 24 h of the onset of ACS improves clinical outcomes and exerts a synergistic effect with DAPT in further reducing PR. This study included 2 841 patients from the ISACS registry (NCT01218776) while the predefined subgroup for PR analysis included 120 patients which were a part of the SPARELIFE project (HRZZ IP-2014-09-8403). Patient survival was analyzed during hospital stay and 30, 90 and 190 days after discharge. PR was analyzed 18h to 24 h after DAPT administration during the acute phase of ACS ad 30 days after discharge using the Multiplate® PFA. Results showed that early statin administration reduces the risk of in hospital (OR 0,25, 95% CI 0,12 – 0,51, p < 0,001), 30-day (OR 0,37, 95% CI 0,18 – 0,73, p = 0,004) and 90-day (OR 0,37, 95% CI 0,19 – 0,73, p = 0,004) mortality while atorvastatin 80 mg does not affect PR assessed using the Multiplate® ADP test (p = 0,926). These results confirm the hypothesis about the beneficial effects of the administration of rosuvastatin or atorvastatin in maximum doses within 24 h of ACS hospitalization. This effect is present in the modern era of revascularization which utilizes DES and potent antithrombocyte drugs. We have also proven that atorvastatin 80 mg does not significantly impact PR modified by ticagrelor and acetylsalicylic acid.