| Background:Atherosclerosis (AS) is a chronic, progressive.and inflammatory artery disease, characterized by lipid accumulation, inflammatory cell infiltration, smooth muscle cell migration and extracellular matrix degradation. The precise pathological mechanisms of AS are remained to be clarified Several reports suggest that statins may confer cardiovascular benefits in addition to their well-known cholesterol-lowering effects, at least partly by modulating the inflammatory arm of atherosclerosis, improving endothelial function, down-regulating adhesion molecules and chemokines and reducing oxidative stress. The atheroprotective and plaque-stabilizing role of statins, which are proved to be independent of their lip-lowering effect, render them top choice in treatment of patients with both ACS and chronic stable angina (CSA). We do believe that novel mechanisms underlying the atheroprotective effects of statins will be unveiled in the future studies.Objective:To observe the difference effective of several sequential therapy of statins for the patients that had been treated with PCI above6months in china. In order to provide the determination for the dose of sequential therapy of statins for PCI patients in China, and hope to provide evidence-based basis for the using of high-dose statin for PCI patients. Materials and methods:1. Using "statin/statins sequential","high dose/load","PCI/percutaneous coronary intervention" as subject term, we search for all relevant articles in Wanfang and CNKI during the period from2000January to2012December.2. All eligible studies were randomized controlled trials, and the selected patients accept high-dose statin therapy during hospitalization after percutaneous coronary intervention, and then observed the incidence of cardiovascular events or inflammatory factor level.3. The eligible studies must be selected according to the following exclusion criteria strictly:(1) Without using cardiovascular events or high-sensitivity C-reactive protein level as the evaluation criteria for the study;(2)Follow-up time is too short(less than six months);(3) Duplicate publication or Multiple contributions (4) Unable to obtain complete documentation of the study during the search process;(5) Obvious problems of the original data or the design of the study is not clear.4. The studies which through preliminary searching and screening should be rated by the Jadad scale.5. Review Manager5.0will be used for the data analysis of including studies and the comparison between different dose groups. The heterogeneity test use x2, and I2inspection,if P＜0.1the test has heterogeneity and using a random effects model. Otherwise it has consistenty, using a fixed effects model.The incidence of cardiovascular events and hs-CRP levels in this meta-anaylsis are from the original data of the studies, P＜0.05for the difference was statistically significant. And funnel plot is used to evaluate published offset.Result:1. The hs-CRP level of statins sequential therapy group after6months is significantly lower than the placebo.2. Statins sequential trerapy group has a lower incidence of cardiovascular events for the PCI patients after6months comparing with the placebo 3. Comparing with the normal does, the sequential therapy of statins is not growing the incidence of adverse reaction results for the patients, P=0.29.Conclusion:Our results from meta-analysis results suggest that sequential therapy of statins can significantly reduce both the incidence of cardiovascular events in the patients with CHD undergoing PCI and plasma CRP levels,which had been proved be associated with the life quality and long-term prognosis in this patient cohort improve the patient’s quality of life and improve the prognosis. And according to this our results, sequential therapy with statins can be secure and operative in clinical practice... |
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