负荷剂量阿托伐他汀对非ST段抬高急性冠状动脉综合征经皮冠状动脉介入治疗预后影响的研究

被引:9
作者
于兴隆
耿静
吴婷婷
刘光辉
郭雪原
陈文强
季晓平
张运
葛志明
机构
[1] 山东大学齐鲁医院心内科教育部和卫生部心血管重构和功能研究重点实验室
关键词
经皮冠状动脉介入治疗; 心肌损伤; 炎症反应; 阿托伐他汀;
D O I
暂无
中图分类号
R541.4 [冠状动脉(粥样)硬化性心脏病(冠心病)];
学科分类号
1002 ; 100201 ;
摘要
目的探讨负荷剂量阿托伐他汀对非ST段抬高急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)后的影响。方法将2009年6—10月山东大学齐鲁医院收集的81例NSTE-ACS患者随机分为负荷组和对照组,负荷组PCI前12h顿服阿托伐他汀80mg,术前2h追加阿托伐他汀40mg。所有患者于术前和术后8h、24h抽取肘静脉血检测肌酸激酶同工酶(CK-MB)、血浆肌钙蛋白(cTNI)和超敏C反应蛋白(hs-CRP)、肌酸激酶(CK)、转氨酶(ALT/AST)。结果 PCI术后2组心肌损伤及炎性反应标志物均有不同程度升高,但负荷组CK-MB、cTNI和hs-CRP水平显著低于对照治疗组(均P<0.01)。负荷组主要不良心脏事件发生率(2.4%)小于对照组(22.5%)(P=0.0161),主要由心肌梗死发生率下降(2.4%对20.0%,P=0.0307)构成。2组患者药物副反应轻微。结论 PCI前阿托伐他汀负荷剂量能减少PCI对NSTE-ACS患者造成的心肌损伤及炎症反应。降低PCI后不良心脏事件的发生,且安全有效。
引用
收藏
页码:820 / 822
页数:3
相关论文
共 13 条
[1]  
Delta caeatine kinase-MB outperforms myoglobin at two hours during the emergency de-partment identification and exclusion of troponin positive non-ST-segment elevation acute coronary syndromes. Fesmire FM,Christenson RH,FodyEP,et al. Annals of Emergency Medicine . 2004
[2]  
Aggressive statin therapy in multicenter and effectiveness for the reduction of intra-myocardi-aldamage caused by non-STelevation acute coronary syndrome:A-MERICA study. Hara H,Nakamura M,Yokouchi I,et al. Ther Adv Cardiovasc Dis . 2009
[3]  
Outcomes associated with drug-eluting and bare-metal stents:a collaborative network meta-analysis. Stettler C,Wandel S,Allemann S,et al. The Lancet . 2007
[4]  
Atorvastatin Pretreatment Improves Outcomes in Patients With Acute Coronary Syndromes Undergoing Early Percutaneous Coronary Intervention. Giuseppe P,Vincenzo P,Giuseppe C, et al. The American Journal of Cardiology . 2007
[5]  
Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. Ridker P M,Rifai N,Rose L,et al. New England Journal of Medicine, The . 2002
[6]  
Intensive lipid lowering with atorvastatin in patients with stable coronary disease. LaRosa JC,Grundy SM,Waters DD,et al. The New England Journal of Medicine . 2005
[7]   C-reactive protein predicts long-term mortality independently of low-density lipoprotein cholesterol in patients undergoing percutaneous coronary intervention [J].
Razzouk, Louai ;
Muntner, Paul ;
Bansilal, Sameer ;
Kini, Annapoorna S. ;
Aneja, Ashish ;
Mozes, Joshua ;
Ivan, Ana ;
Jakkula, Madhavi ;
Sharma, Samin ;
Farkouh, Michael E. .
AMERICAN HEART JOURNAL, 2009, 158 (02) :277-283
[8]  
High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial. Pedereen TR,Faergeman O,Kastelein JJ,et al. The Journal of The American Medical Association . 2005
[9]  
The effects of atorvastatin therapy on endothelial function in patients with coronary artery dis-ease. Yildiz A,Cakar MA,Baskurt M,et al. Cardiovascular Ultrasound . 2007
[10]  
C-reactive protein predicts long-term mortality independtiy of low-density lipoprotein choles-terol in patients undergoing percutaneous coronary intervention. Razzouk L,Muntner P,Bansilal S,et al. American Heart Journal . 2009