The Clinical Effects Of Intensive Statin Therapy On Acute Coronary Syndrome With Percutaneous Coronary Intervention

Objective To observe the results of clinical effects, some biochemical indicators, major adverse cardiovascular events(MACE), safety index and the situation of coronary angiography with one year follow-up after intensive statin therapy in treatment of acute coronary syndrome(ACS) with percutaneous coronary intervention(PCI), aim to observe the efficacy and safety of intensive statin therapy, and to explore whether intensive statin therapy is proper for Chinese. Method The ACS patients(n=142)intending to PCI were selected from November,2012 to November,2014 in the cardiology of The Lanzhou University Second Hospital, and then randomly divided into routine group(n=70) and intensive group(n=72). All baseline data including all of biochemical indicators were collected after hospitalization. The routine group was given atorvastatin (20mg qn) and intensive group was given atorvastatin (80mg)immediately before PCI and then followde with atorvastatin(40mg qn) for maintenance treatment. By observing the changes of blood TC, LDL-C, hs-CRP, ALT, Cr, CK-MB and Glu after discharge in following first, third, sixth, and 12th months in two groups, and meanwhile MACE,,including myocardial infarction angina, heart failure, recurrent myocardial infarction, and cardiac death were evaluated within 12 months). The patients accepted coronary artery angiography again after 12 months, to evaluate the restenosis compared with one years ago.Results The levels of plasma TC and LDL-C decreased in two groups after one year’s follow-up and were decreasing with treatment time expansion,which was more significant in intensive group(P<0.05). The level of hs-CRP was decreased in early period (P<0.05). There was no statistical difference in ALT, Cr, CK-MB and Glu in two groups (P>0.05).The recurrence rate of angina and incidence of heart failure were lower in intensive group than those in routine group(angina:10.3%vs.28.6%,heart failure:8.3%vs.20.0%).There was no statistical difference in recurrence myocardial infarction and cardiac death between two groups(P>0.05). Coronary angiography showed intensive statin had less stent stenosis than that of the routine therapy group, but no statistical difference in stent stenosis (P> 0.05).Conclusion Early high-dose atorvastatin therapy and followed with 40mg/d could reduce the level of blood TC and LDL-C-hs-CRP and the incidence of MACE, as well as good tolerances.