Kubota Naozumi, Kasai Takatoshi, Miyauchi Katsumi, Njaman Widi, Kajimoto Kan, Akimoto Yoshinori, Kojima Takahiko, Ken Yokoyama, Takeshi Kurata, Hiroyuki Daida
Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Heart Vessels. 2008 Jan;23(1):35-9. doi: 10.1007/s00380-007-1007-8. Epub 2008 Feb 14.
Aspirin is the standard therapy applied after coronary intervention, and statins are also prescribed to prevent secondary coronary heart disease. We assessed the ability of a combination of statins and aspirin to improve the longterm prognosis of patients after percutaneous coronary intervention (PCI). We collected data from 575 consecutive patients who underwent PCI. The patients were divided into groups depending on the presence or absence of statin or aspirin therapy as follows: both statin and aspirin (Group B: n = 190; 33%); aspirin only (Group A: n = 236; 41.1%); statin only (Group S: n = 53; 9.2%S); neither drug (Group N: n = 96; 16.7%). Data were statistically assessed using the Cox proportional hazard model for multivariate analysis with adjustment of baseline convariates. Sixty-eight patients died during follow-up (11 +/- 3 years). Multivariate analysis showed that compared with group N, both groups S and A were independent predictors for survival from all causes [group S: hazards ratio (HR) 0.29, 95% confidence interval (CI) 0.10-0.81, P = 0.019; group A: HR 0.31, 95% CI 0.17-0.56, P < 0.0001] and cardiovascular (CV) death (group S: HR 0.16, 95% CI 0.04-0.73, P = 0.018; group A: HR 0.12, 95% CI 0.05-0.30, P < 0.001). risk for all causes and CV death was significantly lower in Group B (HR 0.25, 95% CI 0.12-0.53, P < 0.0001 and HR 0.10, 95% CI 0.03-0.31, P < 0.0001, respectively). Therapy with statins plus aspirin improves long-term clinical outcome in patients after PCI.
阿司匹林是冠状动脉介入治疗后应用的标准疗法，他汀类药物也被用于预防继发性冠心病。我们评估了他汀类药物与阿司匹林联合使用改善经皮冠状动脉介入治疗（PCI）后患者长期预后的能力。我们收集了575例连续接受PCI治疗患者的数据。根据是否接受他汀类药物或阿司匹林治疗，将患者分为以下几组：他汀类药物和阿司匹林联合使用组（B组：n = 190；33%）；仅使用阿司匹林组（A组：n = 236；41.1%）；仅使用他汀类药物组（S组：n = 53；9.2%）；两种药物均未使用者（N组：n = 96；16.7%）。使用Cox比例风险模型对数据进行统计学评估，以对基线协变量进行调整后进行多变量分析。68例患者在随访期间死亡（11±3年）。多变量分析显示，与N组相比，S组和A组均是全因生存的独立预测因素[S组：风险比（HR）0.29，95%置信区间（CI）0.10 - 0.81，P = 0.019；A组：HR 0.31，95% CI 0.17 - 0.56，P < 0.0001]以及心血管（CV）死亡（S组：HR 0.16，95% CI 0.04 - 0.73，P = 0.018；A组：HR 0.12，95% CI 0.05 - 0.30，P < 0.001）。B组全因和CV死亡风险显著更低（分别为HR 0.25，95% CI 0.12 - 0.53，P < 0.0001和HR 0.10，95% CI 0.03 - 0.31，P < 0.0001）。他汀类药物加阿司匹林治疗可改善PCI后患者的长期临床结局。
