| Objective:To observe the effects of atorvastatin loading on myocardial injury, myocardial perfusion..inflammatory response,and cardiovascular events in patients with unstable angina (UA) after percutaneous coronary intervention (PCI). The effi-cacy and safety were compared in different dose of atorvastatin.Methods:Totally 64 patients with UA undergoing PCI in the department of Cardiology in my hospital from September 2012 to October 2013 were randomly divided into large dose group (n=35) and routine dose group (n=29). Large dose group were given a 40mg/d loading dose of atorvastatin, while the routine dose group were given atorvastatin 20ing/d. High-dose group of 35 cases, aged 32-60 years,mean age 50.71±9.1 years old; 21 cases of men, women 14 cases. Routine dose group 29 cases, aged 38-60 years, mean age 48.96±10.3 years old; 18 cases of men and women in 11 cases. All patients use conventional drugs of coronary heart disease (CHD) before PCI; Both groups started taking atorvastatin on admission, high-dose group of 40mg/d,5 days later undergoing PCI, postoperative to 20mg/d; Routine dose group of 20mg/d,5 days later undergoing PCI, postoperative to 20mg/d;Levels of serum MB isoenzyme of creatine kinase (CK-MB), troponin I (Tnl), low density lipoprotein (LDL-C), ALT, CRP were measured on admission,6h before PCI,24h and 30d after PCI. While coronary flow was measured before and after PCI. Major adverse cardiovascular events (MACEs) were recorded in hospitalization and 30d after discharge.Results:1.The general clinical information between two groups was comparable, such as age,gender,BMI,blood pressure,blood sugar et.2.Two groups of CRP were reduced before PCI, compared with that on admission, which have statistical significance (P<0.05);Two groups of PCI postoperative CRP were higher than preoperative, regular rise which is greater than the high dose group (P< 0.05);30 days after discharge, two groups of LDL-C are relatively lower on admission, high-dose group of LDL-C drop is greater than the conventional group; Two groups of ALT, Scr, CRP is no statistical difference (P> 0.05); 3.The preoperative CK-MB, Tnl differences between the two groups, two groups were higher than preoperative, after PCI routine group rise which is greater than the high dose group, with statistical difference (P< 0.05); 4.There was no difference in the two groups of PCI related to the operation data 5. Before PCI, two groups are all TIMI3t级 after PCI the blood flow of TIMI high dose group were 34 cases of grade TIMI3, TIMI is 2 in 1 case, the conventional dose group were 27 cases of grade TIMI3, TIMI is 2 in 2 cases,, there were significant differences between two groups. (P<0.05),6.During the period of follow-up after discharge were not acute myocardial infarction, cardiac shock, death, urgent revascularization events in hospitalized patients in the two groups. Two groups had not been adverse reactions, such as serious liver and kidney damage, myopathy and so on.Conclusions:1.Two groups of patients discharged from hospital after 30 days of the levels of LDL-C is lower than on admission, two groups of perioperative LDL C level is no statistical difference,Tips to strengthen statin therapy is helpful for LDL-C up to standard early, but short-term benefit strengthening statin therapy before PCI may be associated with the diversity of statin.2.The levels of CRP is higher after PCI than before PCI, and routine group increased obviously, Atorvastatin in inhibiting inflammatory reaction is effective, especially in the inflammatory response of PCI related application of high-dose atorvastatin anti-inflammatory effects are more significant3. The levels of CK-MB, Tn1 is higher after PCI than before PCI, and routine group increased obviously, prompt PCI lead to myocardial damage, while high-dose atorvastatin can reduce the degree of myocardial damage, protect myocardial function.4.The slow flow rate is lower in large dose group after PCI than that in normal group, prompt high-dose atorvastatin can effectively reduce the slow flow events.5.Two groups of patients were not serious cardiovascular events, no serious adverse reaction occurred, prompt strengthening preoperative treatment with atorvastatin cardiovascular protection, safe and effective... |
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