摘要
目的探讨阿托伐他汀序贯治疗[冠状动脉介入术前24 h内给予阿托伐他汀80 mg,PCI后给予阿托伐他汀每天40 mg,使用1个月]对择期冠状动脉介入患者的有效性和安全性。方法 328例接受择期PCI术患者分为阿托伐他汀序贯治疗组(n=127)和常规治疗组(n=201)。主要终点为围手术期心肌梗死[定义为肌酸激酶同工酶(CK-MB)大于正常上限值(ULN)3倍],次级终点为30天主要不良心脏事件(MACE)(复合终点,包括全因死亡、心肌梗死、靶病变血运重建)。谷丙转氨酶(GPT)≥3倍ULN作为安全性终点。结果患者无失访。序贯治疗组和常规治疗组围手术期心肌梗死发生率分别为8.7%和17.9%(OR为0.435,95%CI为0.212～0.889,P=0.020),序贯治疗组30天MACE发生率为9.4%,明显低于常规治疗组的18.4%(OR为0.435,95%CI为0.231～0.925,P=0.027)。两组出现GPT≥3倍ULN分别有5例(3.94%)和1例(0.5%)(P=0.034)。结论在择期PCI患者中,阿托伐他汀序贯治疗可减少围手术期心肌梗死及30天MACE,但应警惕转氨酶升高。
Ahn To assess the efficacy and safety of sequential therapy with atorvastatin （80 mg atorvastatin pre- treatment within 24 hours before percutaneous coronary intervention （PCI） and following 40 mg atorvastatin for one month after PCI） in patients undergoing elective PCI. Methods 328 patients undergoing elective PCI were grouped into atorvastatin sequential therapy （ ST group, n = 127） or routine therapy （ RT group, n = 201 ）. The primary endpoint was peri-procedural myocardial infarction （ defined as a CK-MB elevation 〉 3 times upper limit of normal levels （ULN） ） and the second endpoint was 30-day major adverse cardiac event （ MACE, a composite end point, including all-cause death, MI, target-lesion revascularization）, respectively. Glutamic pyruvic transaminase （GPT） elevation ~〉 3 times ULN as a safety endpoint was also addressed. Results No patient had loss of follow-up. The incidence of peri-procedural my- ocardial infarction was 8. 7% in the ST group and 17. 9% in the RT group （ odds ratio： 0. 435, 95% confidence interval： 0. 212 to 0. 889, P = 0. 020）. The incidence of 30-day MACE was 9.4% in the ST group and 18.4% in the RT group （odds ratio： 0.435, 95%confidence interval： 0.231 to0.925, P=0.027）. GPT elevation /〉3 times ULN occurred in5 cases in the ST group and 1 case in the RT group （3.94% in the ST group vs 0. 5% in the RT group, P-0. 034）. Conclusion Atorvastatin sequential therapy reduces peri-procedural myocardial infarction and 30-day MACE but may re- sult in more elevated aminotrasferase ≥3 times ULN in patients undergoing elective PCI.
出处
《中国动脉硬化杂志》
CAS
CSCD
北大核心
2012年第9期824-828,共5页
Chinese Journal of Arteriosclerosis
基金
福建医科大学苗圃基金资助(2010MP042)
关键词
择期经皮冠状动脉介入术
阿托伐他汀
序贯治疗
围手术期心肌梗死
Elective Percutaneous Coronary Intervention
Atorvastatin
Sequential Therapy
Peri-ProceduralMyocardial Infarction
