The Effect Of Atorvastatin On Inflammatory Markers And Endothelial Function In Patients With ACS Before And After PCI

Objective To study the effect of atorvastatin on inflammatory markers and endothelial function in patients with acute coronary syndrome(ACS)before and after percutaneous coronary intervention(PCI).To assess if different dose atorvastatin result in different outcome.Methods A total of 69 patients with ACS were randomized into three groups:atorvastatin 10mg/d or 20mg/d or 40mg/d,PCI were underwent after two weeks,serum levels of high sensitivity C-reactive protein(hs-CRP),nitric oxide synthase(NOS),lipid and alanine aminotransferase(ALT)were measured at baseline,before PCI(the early morning of the procedure)and 48 hours after PCI.Results 1.(1)There were no significant diffenence between three groups of baseline hs-CRP(P＞0.05).(2)hs-CRP was significantly reduced pre-PCI in three groups compared to baseline,and it was lowest in group 40mg,it was lower in group 20mg than that in group 10mg(all P＜0.05).(3)Compared to pre-PCI,hs-CRP of post-PCI was significantly increased in three groups,it was highest in group 10mg,it was higher in group 20mg than that in group 40mg.2.(1) There were no significant diffenence between three groups of baseline NOS(P＞0.05).(2)NOS was significantly increase in pre-PCI in three groups compared to baseline,and it was highest in group 40mg,it was higher in group 20mg than that in group 10mg(all P＜0.05).(3)NOS was significant reduction in three groups in post-PCI,it was lowest in group10mg,it was lower in group 20mg than that in group 40mg(all P＜0.05).3.There were no correlation between the change of hs-CRP,NOS and lipid lowering.4 The ALT increased 3 times higher than normal in group atorvastatin 40mg,20mg and 10mg respectively is2,1,and 0,the ALT increased lower than 3 times respectively 9vs5 vs 2,most ALT can recover after several weeks.conclusion(1)The result suggested that the PCI could lead to a significant increase the serum level of hs-CRP and significantly decrease the level of NOS in ACS patients post-PCI.(2) Atorvastatin could significantly decrease the level of hs-CRP and increase the level of NOS.(3) Its effect was dose-dependent,the benefit of atorvastatin beyond that of lipid lowering.(4) Atorvastatin 40mg and 20mg were safety.