Effect of atorvastatin combined with ezetimibe on perioperative Lp-PLA2 in patients with non-ST-segment elevation acute coronary syndrome after PCI
10.12007/j.issn.0258-4646.2024.07.001
- VernacularTitle:阿托伐他汀联合依折麦布对非ST段抬高型急性冠脉综合征患者PCI围手术期Lp-PLA2的影响
- Author:
Changbin LIANG
1
;
Fuliang ZHOU
;
Dalin JIA
Author Information
1. 中国医科大学附属第一医院心血管内科,沈阳 110001
- Keywords:
non-ST-segment elevation acute coronary syndrome;
percutaneous coronary intervention;
lipoprotein-associated phospholi-pase A2;
atorvastatin;
ezetimibe
- From:
Journal of China Medical University
2024;53(7):577-582,590
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the periprocedural effects of atorvastatin plus ezetimibe and atorvastatin monotherapy on lipopro-tein-associated phospholipase A2(Lp-PLA2)levels in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)after percutaneous coronary intervention(PCI).Methods In total,193 patients with NSTE-ACS who underwent PCI were divided into four groups:20 mg atorvastatin(A20 group),40 mg atorvastatin(A40 group),20 mg atorvastatin combined with 10 mg ezetimibe(A20+E10 group),and 40 mg atorvastatin combined with 10 mg ezetimibe(A40+E10 group).Changes in plasma Lp-PLA2 and low-density lipopro-tein cholesterol(LDL-C)levels during the perioperative period were observed,and major adverse cardiovascular events(MACE)and sta-tin-related adverse reactions were monitored for 30 d.Results Factorial analysis revealed no interaction between intensive atorvastatin and ezetimibe.Intensive atorvastatin and atorvastatin combined with ezetimibe significantly reduced the postoperative plasma Lp-PLA2 levels(P<0.05).Plasma Lp-PLA2 levels were similar between the four groups before PCI and decreased significantly after PCI(P<0.05).The changes in Lp-PLA2 during the perioperative period were compared between the four groups,and it was significantly higher in the A40 group than in the A20 group,in the A20+E10 group than in the A20 group,in the A40+E10 group than in the A20 group,and in the A40+E10 group than in the A40 group(P<0.05).No significant difference in LDL-C levels and no significant correlation between the changes in LDL-C and Lp-PLA2 levels were observed between the four groups(P>0.05).In addition,no significant differences in the incidence of major adverse cardiovascular event or statin-related adverse reactions were observed(P>0.05).Conclusion Compared with atorvastatin(20 mg)monotherapy,both intensive atorvastatin(40 mg)and atorvastatin plus ezetimibe can further reduce postoperative Lp-PLA2 levels,independent of the changes in LDL-C in patients with NSTE-ACS undergoing PCI.