Researchers in Barcelona have discovered that delivering a blood pressure medication directly into the bloodstream during a heart attack proves far more protective than giving the drug by mouth hours before the event occurs. The finding, published in the European Heart Journal by scientists at the Institut de Recerca Sant Pau, challenges conventional thinking about when and how to administer statins—a class of drugs long used to manage cardiovascular risk.
Limiting the damage a heart sustains during a myocardial infarction remains one of cardiology's most stubborn problems, even when doctors successfully restore blood flow to the blocked artery. Part of the injury persists despite modern reperfusion therapies, creating a persistent gap in patient outcomes. Understanding how to minimize this damage in those critical minutes and hours could transform survival rates and long-term heart function.
To test their hypothesis, researchers led by Gemma Vilahur, Ph.D., head of the Molecular Pathology and Therapeutics of Atherothrombotic and Ischemic Diseases Group at IR Sant Pau, used a hypercholesterolemic pig model—animals bred to have high cholesterol levels similar to human patients with cardiovascular disease. This model allowed controlled study of how different treatment approaches affect myocardial injury. The pigs received oral atorvastatin treatment for days before the induced heart attack, mimicking the real-world scenario of patients already taking statins.
The researchers then compared two strategies during the acute event itself. In one approach, pigs received an oral loading dose of atorvastatin two hours before the heart attack was induced. In the other, they received an intravenous formulation of atorvastatin just 15 minutes after the ischemic episode began—a specialized formulation developed at IR Sant Pau that has been patented and commercialized through a spin-off company called Ivestatin Therapeutics S.L. Heart attacks were simulated through controlled balloon occlusion of a coronary artery followed by revascularization, replicating the clinical process patients experience.
The precision of the study came from serial cardiac magnetic resonance imaging—a reference standard for measuring infarct size and tissue damage. Researchers scanned the animals' hearts three days after the event and again 42 days later, capturing both the initial injury and its evolution over time. The two-timepoint follow-up provided an unusually precise window into how the heart recovers.
The results were striking. Intravenous administration during the heart attack significantly reduced myocardial damage in the acute phase compared with the oral loading approach. Animals receiving the intravenous dose showed lower necrosis—meaning less cardiac tissue death—and less edema associated with inflammation. "The main contribution of this study is demonstrating for the first time that intravenous administration of atorvastatin during the ischemic event itself has a significantly greater impact on reducing cardiac damage than administration of a pre-infarction oral loading dose," Vilahur explains.
These findings suggest that the timing and route of drug delivery matter far more than current clinical guidelines acknowledge. While modern medicine already recommends using statins early after heart attack, uncertainty has persisted about their impact during the ischemic event itself—and whether injecting them might prove superior to pills. The Barcelona research provides the first evidence that it does.
As researchers move toward human trials, the work opens a path toward acute interventions that could reshape the first hours after a heart attack, potentially saving cardiac tissue and improving patients' chances of full recovery.