Efficacy Of Different Doses Rosuvastatin Pretreatment On SP-selectin,hs-CRP Changing In Patients With Coronary Heart Disease After PCI

Objective(1)To investigate the efficacy of different doses of rosuvastatin pretreatment before PCI,and observing the serum concentration of inflammatory factors,soluble sP-selectin,hs-CRP changing in patients of coronary heart disease after PCI treatment(2)To observe the trend of sP-selectin,hs-CRP changing in CHD patient after PCI during the short time,and provide some evidences for clinical durg therapy.(3)To compare the different doses of rosuvastatin,the ability of inbition of inflammatory response,reducing the inflammatory factors and myocardial protection,providing a basical theory for best doses of drug for clinical treatment.MethodsEighty CHD patiens under successful PCI treatment in YueYang Fisrt People hospital,were randomly separated into three groups:the rosuvastatin 5mg dose pretreatment as low-dose pretreatment Group(n=20); the rosuvastatin 10mg pretreatment as moderate-doses pretreatment Group(n=30); the rosuvastatin 20mg pretreatment as high-doses pretreatment Group(n=30). The method of speation of groups:the three groups patients before the PCI operation,were respectively given rosuvastatin 5mg, rosuvastatin lOmg and 20mg per night for 3 days.The level of Peripheral venous serum sP-selectin,hs-CRP were measured with ELISA,before,24 hours after,48hous and 1 week later after PCI treatment.Results(1)There was no significant difference about the gender composition, BMI,the average age,history of high blood cholesterol and diabetes mellitus among the three groups of patients(P> 0.05).However,proportion of history of hypertension was highest in the moderate -dose pretreatment group,in the high-dose pretreatment group,the proportion of smoking was highest,stent number was the largest (P<0.05)(2) The level of inflammatory factors of three groups before PCI stage, there were no significant difference between the moderate-dose pretreatment group,the high-dose pretreatment group,and the low-dose group. (P>0.05) The concentrations of sP-selectin,hs-CRP were significantly increased in the stages of 24 hours after PCI,and 48 hours after PCI,there were significant difference between three groups (P< 0.05).Where the concentrations of sP-selectin reached the peak at 24hours after PCI,and decreased to preoperation levels after one week later. While the concentrations of hs-CRP reached the peak at 48hours after PCI;and decreased to preoperation levels after one week later. (3)△sP-selectin means the elevated degree of sP-selectin concentration changing during the period of preoperative stage and 24 hours after PCI, there were significant difference between the three groups, of which statin pre-treatment of moderate-dose group and high dose group△sP-selectin were both lower than the low-dose group,the high-dose group and the low-dose group (2.22±0.56 VS 3.87±1.35 ng/ ml, P<0.05); the moderate-dose group and the low-dose group (4.09±0.64 VS 3.87±1.35 ng/ml, P<0.05); while the moderate-dose group and high dose group, (4.09±0.64 VS 2.22±0.56 ng/ml, P<0.05). the moderate-dose group△sP-selectin greater than the high dose group.△hs-CRP means the elevated degree of hs-CRP concentration changing during the period of preoperative stage and 48 hours after PCI, there were significant difference between the three groups, (P< 0.05).The△hs-CRP of the moderate-dose pretreatment group and the high-dose pretreatment were both lower than the low-dose group, high-dose Group and low-dose group (4.96±1.28 VS 8.85±1.06 mg/L, P<0.05); moderate-dose group and low-dose group (5.91±4.42 VS 8.85±1.06 mg/L, P<0.05). moderate-dose group and between the high dose group (5.91±0.42 VS 4.96±1.28 mg/L, P<0.05), the moderate-dose group△hs-CRP greater than the high dose group.(4)△sP-selectin was not correlated to△hs-CRP, cTnI, and the number of stents (P>0.05) (5)Perioperative myocardial infarction was defined as cardiac troponin postoperative greater than 3×99th percentile of the upper reference limit.The incidence of peri-procedural MI in high-dose pretreatment group was the lowest(3.4%),but there was no significant difference among groups (P=0.218)(6)The blood lipid levels, serum muscle enzymes concentraction, liver and kidney function were measured at preoperative and postoperative stage, there were no significantly change among the three groups(P> 0.05)Conclusions(1) The concentraction of inflammatory factor hs-CRP, sP-selectin were highly increased after PCI treatment, suggesting that the inflammatory reaction was activated after PCI, and inducing the amount of inflammatory factors released.(2) We can find the result of this experiment that different doses Rosuvastatin pretreatment before PCI,all of (moderate-dose 10mg/d,and high dose 20mg/d,and low-dose 5mg/d),which can inhibit the inflammatory response after PCI and reducese the inflammatory factors releasing,and also possess the effection of cardioprotect during the PCI process. The anti-inflammation effection of rosuvastatin were doses-dependent, in our study that show the high dose pretreatment group 20mg/d have more benefit for Myocardial protection,and the strongest anti-inflammation effection than the other dose groups.(3) Rosuvastatin inhibition of inflammatory response, which was independent of the lipid-lowering effect, it can provide some evidence for pleiotropic effection of statin.