Atorvastatin improves reflow after percutaneous coronary intervention in patients with acute ST-segment elevation ;myocardial infarction by decreasing serum uric acid level
10.3785/j.issn.1008-9292.2016.09.12
- VernacularTitle:阿托伐他汀可改善急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后无复流现象
- Author:
Ling YAN
1
;
Lu YE
;
Kun WANG
;
Jie ZHOU
;
Chunjia ZHU
Author Information
1. 安徽省铜陵市人民医院心内科
- Keywords:
Hyperuricemia/drug therapy;
Myocardial infarction/therapy;
Angioplasty,transluminal,percutaneous coronary/methods;
Heptanoic acids/therapeutic use;
Pyrroles/therapeutic use;
No-reflow phenomenon
- From:
Journal of Zhejiang University. Medical sciences
2016;45(5):529-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effect of atorvastatin on reflow in patients with acute ST-segment elevation myocardial infarction ( STEMI ) after percutaneous coronary intervention ( PCI) and its relation to serum uric acid levels .Methods: One hundred and fourteen STEMI patients undergoing primary PCI were enrolled and randomly divided into two groups:55 cases received oral atorvastatin 20 mg before PCI ( routine dose group ) and 59 cases received oral atorvastatin 80 mg before PCI ( high dose group ) .According to the initial serum uric acid level , patients in two groups were further divided into normal uric acid subgroup and hyperuricemia subgroup . The changes of uric acid level and coronary artery blood flow after PCI were observed . Correlations between the decrease of uric acid , the dose of atorvastatin and the blood flow of coronary artery after PCI were analyzed .Results: Serum uric acid levels were decreased after treatment in both groups ( all P<0 .05 ) , and patients with hyperuricemia showed more significant decrease in serum uric acid level ( P<0 .05 ) . Compared with the routine dose group , serum uric acid level in patients with hyperuricemia decreased more significantly in the high dose group (P<0.05), but no significant difference was observed between patients with normal serum uric acid levels in two groups ( P>0 .05 ) .Among 114 patients , there were 19 cases without reflow after PCI (16.7%).In the routine dose group, there were 12 patients without reflow, in which 3 had normal uric acid and 9 had high uric acid levels ( P<0.01).In the high dose group , there were 7 patients without reflow , in which 2 had normal uric acid and 5 had high uric acid ( P <0.05 ).Logistic regression analysis showed that hyperuricemia was one of independent risk factors for no-reflow after PCI ( OR=1.01, 95%CI:1.01-1.11, P<0.01).The incidence of no-flow after PCI in the routine dose group was 21.8%(12/55), and that in the high dose group was 11.9%(7/59) ( P<0 .01 ) .Conclusion: High dose atorvastatin can decrease serum uric acid levels and improve reflow after PCI in patients with STEMI .
