A comparison between efficacy of treatment with a single loading dose and a regular dose of rosuvastatin before percutaneous coronary intervention in elderly patients with coronary artery disease
10.3969/j.issn.1008-9691.2015.06.013
- VernacularTitle:经皮冠状动脉介入术前单次负荷剂量与常规剂量瑞舒伐他汀对老年冠心病患者预后影响的比较
- Author:
Jie QI
;
Xiaofei WANG
;
Lei WANG
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Rosuvastatin;
Contrast induced nephropathy;
Myocardial infarction;
Major adverse cardiac vascular event
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;(6):606-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of treatment with a single loading dose of rosuvastatin before percutaneous coronary intervention (PCI) for prevention of complications after surgery in elderly patients underwent PCI with coronary artery disease.Methods 216 elderly patients with coronary artery disease admitted to Department of Cardiology of Tianjin First Center Hospital were divided into two groups at random (108 patients per group). Within 24 hours before PCI, the patients of loading dose group received a loading dose of rosuvastatin 20 mg, while the patients of regular dose group received a regular dose of rosuvastatin 5 mg, and after surgery, both groups received rosuvastatin 5 mg/d orally. The serum creatinine (SCr), endogenous creatinine clearance rate (CCr), cardiac Troponin I (cTnI), creatine kinase-MB isoenzyme (CK-MB) and hypersensitive C-reactive protein (hs-CRP) before and after PCI were detected, and the incidences of contrast induced nephropathy (CIN) and myocardial infarction were calculated in both groups. The patients were followed up for 1 year after PCI, and the incidence of major adverse cardiac events (MACE) was observed.Results There were no statistically significant differences in the levels of SCr, CCr, cTnI, CK-MB or hs-CRP before PCI between two groups (allP > 0.05). While after PCI in two groups, the levels of SCr, cTnI, CK-MB and hs-CRP were higher than those before PCI, but CCr was lower than that before PCI, and the changes in regular dose group were more significant as compared with loading dose group [SCr (μmol/L): 89.52±21.79 vs. 83.45±19.17, cTnI (μg/L): 0.49±0.23 vs. 0.35±0.18, CK-MB (μg/L): 5.98±1.16 vs. 3.05±0.71, hs-CRP (mg/L): 8.31±0.06 vs. 2.46±0.02, CCr (mL/min): 62.61±19.54 vs. 73.48±20.14, allP < 0.05]. The incidence of CIN [7.41% (8/108) vs. 17.59 (19/108)] and myocardial infarction [1.85% (2/108) vs. 8.33% (9/108)] in loading dose group was evidently lower than that in regular dose group (bothP < 0.05). The incidence of MACE within 30 days after PCI in loading dose group was lower than that in regular dose group [5.56% (6/108) vs. 13.89% (15/108),P < 0.05], while within 1 year after PCI, the comparison of MACE incidence between loading dose group and regular dose group showed no statistically significant difference [19.44% (21/108) vs. 27.78% (30/108),P > 0.05].Conclusion A single loading dose of rosuvastatin given before PCI in elderly patients with coronary cardiac disease can protect renal function and myocardium, reduce the incidences of CIN, myocardial infarction and the occurrence of MACE at early stage after PCI.
