Clinical trial of rosuvastatin on patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention
10.13699/j.cnki.1001-6821.2017.18.001
- VernacularTitle:瑞舒伐他汀治疗急性ST段抬高型心肌梗死患者经皮冠状动脉介入术后的临床研究
- Author:
Qing LU
1
;
Shi-Fang DING
;
Zhi-Nan CHEN
;
Ju-Quan JIANG
;
Zhi-Gang GONG
;
Zhi-Gang LI
;
Wen-Bo FU
;
Mi ZHOU
Author Information
1. 中国人民解放军武汉总医院心血管内科
- Keywords:
rosuvastatin;
ST-segment elevation myocardial infarction;
myocardial reperfusion;
primary percutaneous coronary intervention
- From:
The Chinese Journal of Clinical Pharmacology
2017;33(18):1735-1739
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of rosuvastatin on myocardial reperfusion and the recent clinical efficacy of patients with ST-segment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI) with/without the chronic pre-treatment of statins.Methods A total of 170 STEMI patients after primary PCI were enrolled.According to the history with the pre-treatment of statins,the patients were divided into long-term intervention group (pre-treatment of statins more than 3 months,n =45) and no long-term treatment group (without pre-treatment of statins or with less than 3 months pre-treatment of statins,n =125) patients.The no long-term treatment group was then randomly divided into the high dose group(n =64) and conventional dose group(n =61).The patients in high dose group were orally given treated with rosuvastatin 20 mg orally before PCI,and treated with rosuvastatin 10 mg qn after PCI,while the patients in the other two groups were treated with 10 mg rosuvastatin orally before PCI,and given rosuvastatin 10 mg qn after PCI.The three groups were treated for 40 d.All patients were orally given aspirin 300 mg + clopidogrel 600 mg before PCI,and treated with aspirin 100 mg qd + clopidogrel 75 mg qd after PCI for at least 12 months.Myocardial reperfusion,left ventricular end-diastolic dimension (LVEDD),fractional shortening (FS) and Left ventricular ejection fraction (LVEF),major adverse cardiovascular events(MACEs) and adverse drug reactions were compared among the three groups.Results In the high dose group,long-term intervention group and the conventional dose group,the rates of TIMI 3 grade were 93.75％,95.56％ and 85.25％ respectively,while the rates of STR were 93.75％,95.56％ and 86.89％,and the incidence of reperfusion arrhythmia was 60.94％,57.78％ and 36.07％.Significant differences were found in all the parameters above among all groups (P ＜ 0.05).Forty days after PCI,in the three groups LVEDD were (52.80 ± 4.82),(51.88 ± 4.79) and (52.85 ± 4.72) mm,FS were (39.65 ± 2.89) ％,(40.05 ± 2.25) ％ and (34.05 ± 2.89) ％,and LVEF were (53.78 ± 6.92)％,(54.08 ± 6.22)％ and(47.05 ± 6.10)％,the differences were statistically significant (P ＜ 0.05) when compared with the parameters measured 7 days after PCI.MACEs in the group with pre-treatment of statins were recurrent angina pectoris(1 case),cardiogenic shock (3 cases),heart failure (1 case) and severe ventricular arrhythmia(2 cases),and the incidence of cardiovascular adverse event was 15.56％ (7/45 cases).In high-dose group,MACEs were recurrent angina (3 cases),cardiogenic shock (1 case),heart failure (4 cases),severe ventricular arrhythmia (3 cases),death (1 case);the incidence of cardiovascular adverse events was 18.75％ (12/64 cases),and statistically significant differences were found when compared with the conventional dose group (P ＜ 0.05).Conclusion Conventional dose pre-treatment of rosuvastatin was able to further alleviate the ischemic myocardial reperfusion and improve the recent clinical efficacy for STEMI patients with long-term pre-treatment of statins after primary PCI.
