The Efficacy And Safety Of Intensive Atrovastatin Treatment In Patients With Nstemi Or UA After PCI

Objectives:To observe the efficacy and safety of intensiveatrovastatin therapy on in patients with unstable angina or non-STelevated myocardial infarction after PCI.Methods:66patients,first diagnosed CHD ACS(only includingUA or NSTEMI) in which40males and26females(the mean age63.03±5.85years old),were enrolled to our study from August2010toJune2011.All cases were diagnosed by CAG and received PCI treatmentin the first affiliated hospital of Chongqing Medical University.Afterhospitalized the patients were randomly divided into2groups:Intensive statin therapy group (group I,including20males，14females,mean age63.82±5.41years old)and Routine statin therapy (groupR,20males,12females,mean age62.19±6.35years old).The patients ingroup I received Atorvastatin80mg daily for2days before CAG and PCItreatment,and then the dosage was changed into40mg daily last for1mouth. After1mouth treatment,the dosage again was changed into20mgtill the6th month(the endpiont of this study).The patients in group R received Atorvastatin the routine dosage20mg daily till the endpiont ofthis study. Medicines were administrated to all cases such as Aspirin100mg/d、Clopidogrel75mg/d、Heparin（Clexane）、Nitrade、B-blocker（Metoprolol tablets47.5mg/d）、ACEI（Perindopril2mg/d.Bloodsamples were collected the day after admission、24h after PCI、the1stmonth on an empty stomach to examine the levels of hs-CRP、CK-MB、cTnt，as well as TC、TG、LDL-C、HDL-C、 ALT、AST、CK、Tbilwere examined at the time point of admission、the1stmonth、the3rdmonth、 the6th month treatment with atrovastatin. These markersanalyzed by SPSS17.0for windows.P values <0.05were consideredstatistically significant.Results: There were no significant statistics differences in age、gender distribution、abuse of smoking and alcohol、the histories ofhypertension、diabites between group I and group R.All patients finishedthe6months follow up.After6months treatment with statin,LDL-C、TC、TG were lowered in both group,but lowered more significant in group Ithan in group R，especially LDL-C（1.70±0.61vs1.81±0.54,P<0.01）.HDL-C elevated in both group,but elevated more significant in group Icompared to group R(1.38±0.31vs1.17±0.22,P<0.01).at the same time theLDL-C in group I meet a significant high requirement than that of group Rafter6months treatment with atrovastatin (85.30%vs68.75%,P<0.05).CK-MB,cTnt and hs-CRP，at the time point of24h after PCI, elevated in both group,especially in group R (3.34±0.51vs2.21±0.45;1.89±0.72vs1.52±0.35;21.34±5.10vs18.51±3.23,P<0.05），and then decreased at the1month time point in both group,moresignificantly decreased in group I (1.84±0.40vs2.03±0.51;0.001±0.000vs0.023±0.000;1.20±0.35vs8.47±0.52,P<0.05).The MACEs has nodifferences in both group,but the incidence of drug adverse reaction higherin group I(8.8%vs3.1%,P<0.05),and the incidence of ALT>3UNL was2.9%(1/34) in group I compare to0%in group R.The ALT、AST、CK、Tbil levels were no significant differences in both group,also after6monthsfollow-up. P>0.05.Conclusions:1. Intensive statin therapy not decrease the levels of TC、TG、LDL-C more significantly, but also elevate HDL-C than routine statintherapy;2.Intensive statin therapy may protect myocardial by decrease hs-CRP、CK-MB、cTnT after PCI；3.Intensive statin therapy has no apparent harms to liver;4.Intensive statin therapy can decrease the incidence of MACEs afterPCI,but increase the incidence of drug adverse reaction.