The Impact Of ACVE And PPL With The Treatment Of Statin In Patients With AMI

Objectives:(1) To observe the occurrence of adverse cardiovascular events (ACVE) and postprandial lipid(PPL) in patients with acute myocardial infarction(AMI) within 6 months,and to evaluate the the impact of PPL to ACVE in AMI patients. (2) To evaluate the impact of rosuvastatin or atorvastatin therapy to PPL and ACVE in patients with AMI within 6 months.Methods:74 AMI patients underwent PCI therapy in our hospital departmentwere randomly divided into:group A (atorvastatin group n=34) and group B (rosuvastatin group n=40). All cases were divided into event group (n=26) and non-event group(n=48) according to whether ACVE occured or not.(1)The occurence of myocardial infarction (RMI), recurrent angina pectoris (RAP), heart failure (HF), cardiac arrhythmias, sudden cardiac death (SCD) will be observed witnin 6 months.(2)All subjects had routine diet and no significant change of dietary pattern and eating habit, then blood sample was taken and lipids include total cholesterol (Tc), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C),non-high-density lipoprotein cholesterol (non HDL-C),were tested 4 hours after breakfast,before hospitalization,3 and 6 months later. (3)The PPL level were compared in event group and non-event group,then evaluate the impact of PPL to ACVE. The PPL level and the occurrence of ACVE in group A were compared with that in group B,then the impact of the occurence of ACVE and PPL level was evaluated in AMI patients with the thetreatment of rosuvastatin or atorvastatin.Results:1、The PPL were compared in event group and non-event group:(1)The Tc, TG, LDL-C and nonHDL-C in event group were significantly higher than those in non-event group,and the difference was statistically significant (P< 0.05),while HDL-C in event group was relatively low, and there was no statistical difference (P> 0.05),after 3 and 6 months.(2)In 66 cases with fasting lipid compliance,the PPL were compared in both events and non-events group after 6 months:The Tc,TG, LDL-C and nonHDL-C in the event group were significantly higher than those in the non-event group, and the difference was statistically significant (P< 0.05).The HDL-C in the event group were lower than those in the non-event group, but have no statistically difference(p> 0.05).2、Before hospitalization,the PPL were compared with fasting state:The postprandial TG was significantly higher compared with fasting state, the difference was statistically significant (P< 0.05), but the rest indexes such as Tc,LDL-C and non-HDL-C were not statistically significant (P> 0.05).3、The PPL were compared in group A and B:(1)The PPL were compared in group A and B and the difference was not statistically significant (P> 0.05),before hospitalization.(2)The PPL were compared between the two groups was not statistically significant difference (P> 0.05),3 and 6 months later.(3)The PPL in both two groups were compared before hospitalization and 6 months later:The Tc, TG, LDL-C, HDL-C, nonHDL-C in both two groups were significantly decreased 6 months later compared with before hospitalization, and the difference was statistically significant (p<0.05),while the HDL-C was increased compared with before hospitalization, but the difference was not statistically significant (p> 0.05).(4)Aftre 6 months,the decline rate of Tc, TG and nonHDL-C in group B is higher than that in group A, and the decline rate of LDL-C in group A is higher than that in group B,but the difference was not statistically significant (p> 0.05).The decline rate of HDL-C was negative, which showed that it was gradually increased with the treatment,but there was no significant difference between the two groups (p> 0.05).4、The occurrence of ACVE in group A and B:The ACVE occurred in both two groups, and the vast majority of ACVE was RAP, but there was no statistical differ ence between the two groups (P> 0.05).Conclusions:1、The PPL may have a relationship with the occurrence of ACVE in patients with AMI.2、Atorvastatin or rosuvastatin therapy could significantly reduce postprandial lipid levels in patients with AMI, and both effect of postprandial lipid was similar.3、The rosuvastatin or atorvastatin therapy in AMI patients have a similar impact on ACVE.4、The postprandial lipids need to be paied attention as fasting lipids in patients with AMI.