经皮冠状动脉介入术前阿托伐他汀强化治疗对预后的影响

目的评价经皮冠状动脉介入术前患者行阿托伐他汀强化治疗对预后的影响。方法60例入选患者术前被随机分为两组，强化治疗组29例患者，术前12小时内服用阿托伐他汀80mg；对照组31例患者，术前12小时内服用阿托伐他汀20mg，所有患者术后均以阿托伐他汀每日20mg，每日1次长期维持。观察两组患者术前及术后24小时的肌酸激酶同工酶、肌钙蛋白I、C反应蛋白等指标的变化，比较两组在出院3个月时主要不良心血管事件发生率。结果强化治疗组主要不良心血管事件发生率为3．4％，对照组为22．6％（P〈0．05）；与对照组相比，强化治疗组患者术后肌酸激酶同工酶、肌钙蛋白I升高幅度显著减低（P〈0．05）；C反应蛋白升高的幅度低于对照组，但两组比较差异无统计学意义（P〉0．05）。结论PCI术前使用80mg阿托伐他汀同常规使用20mg的剂量相比，强化治疗的患者在短期预后方面获益大。

Influence of high dose atorvastatin pretreatment before percutaneous coronary intervention in prognosis

Objective To evaluate the influence of high dose atorvastatin pretreatment before percutaneous coronary intervention in prognosis. Methods A total of 60 patients for PCI were randomized to receive atorvastatin（80 mg loading dose given a mean of 12 h before coronary angiography, n = 29） or control group（20 mg dose given a mean of 12 h before coronary angiography, n = 31 ）. After PC I, all pa- tients received long-term atorvastatin treatment thereafter（20 mg/day）. Levels of creatine kinase-MB, cTnI and C-reactive protein（CRP） were measured at baseline and 24 h after the procedure. The main end point of the trial was a 90-day incidence of major adverse cardiac events. Results The primary end point occurred in 3.4% of patients in the high dose atorvastatin arm and in 22.6% of those in the control group （ P 〈 0.05 ）. Postprocedural elevation of creatine kinase-MB and troponin-I was also significantly lower in the high dose atorvastatin group. The percent increase of CRP levels from baseline was lower in the high dose statin arm. Conclusion Compared with the control group,the trial shows that high dose atorvastatin pretreatment before PCI improves short-term outcomes in patients with coronary heart disease.