The Impact Of Coronary Intervention On Serum C-reactive Protein In Patients With Acute Coronary Syndrome And The Effect Of Proprocedural Aggressive Atorvastatin Theraphy

Background: It has been previously shown that percutaneous coronary intervention triggers systemic inflammatory and is associated with an early rise in CRP.Beyond lipid lowering, statins are known to possess antiinflammatory and antithrombotic properties. Recent studies suggested an association between statins and early reduction in death or myocardial infarction (MI) after percutaneous coronary interventions (PCIs). We sought to examine the interrelationship between inflammation, statin use, and PCI outcomes.Objective: Survey the change of CRP in patients with acute coronary syndrome at12 and 24 hours after PCI. Investigate the effect of proprocedural aggressive atorvastatin theraphy on inflammation, lipid lowering and PCI outcomes. Observation the adverse reaction of aggressive atorvastatin theraphy. To approach the interrelationship between inflammation, statin use, and PCI outcomes.Methods:A total of 81 patients with ACS underwent percutaneous coronary intervention were enrolled, and randomly assigned to aggressive statin administration before percutaneous coronary intervention (80mg 12h and 40mg 2h before elective PCI,80mg before urgent PCI) and nonstatin treatment group . Blood samples were collected before and at 12 and 24 h after PCI to measure the serum levels of CRP.Blood samples were collected before PCI to measure creative kinase-MB,cholesterol,creatinine,AST and ALT.All patients were given a clopidogrel and aspirin 300mg loading dose.All patients received longterm atorvastatin treatment thereafter(40mg/day for one month and 20 mg/day for ever).All patients return hospital at 3 month and 6 month after PCI to measure the serum levels of CRP,creative kinase-MB,cholesterol,creatinine,AST and ALT。The main end point of the trial was a 60-days incidence of major adverse cardiac events(death,myocardial,rehospitalization or unplanned revascularization).Results:There was a significant increase in serum CRP of all patients between baseline and after PCI,and the average levels of serum CRP at 24 hours was higer than at 12 hours. Incidence of major adverse cardiac events in the trial group was lower than in the control group.The average levels of serum CRP in the events group was higer than no events group.The extent of the increased serum CRP was positive correlated to the 6-months incidence of major adverse cardiac events. There were no other adverse effects from statin use such as myositis or myalgia that necessitated patients to quit their participation in this study.conclusionsPercutaneous coronary intervention can trigger and aggravate systemic inflammatory . Inflammatory is correlated to incidence of major adverse cardiac events. Aggressive statin usage before PCI to patients can reduce inflammatory after procedure and decrease the incidence of major adverse cardiac events. There were no serious adverse effects of 40mg/day atorvastatin theraphy.