Chyrchel Michał, Dudek Dariusz, Rzeszutko Lukasz, Dziewierz Artur, Chyrchel Bernadeta, Rakowski Tomasz, Dubiel Jacek S
Department of Interventional Cardiology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Cardiovasc Revasc Med. 2011 Jan-Feb;12(1):2-9. doi: 10.1016/j.carrev.2009.11.001. Epub 2010 Oct 20.
The aim was to assess the impact of the short-term anti-inflammatory therapy on coronary endothelial function in non-ST-segment elevation acute coronary syndrome patients. In 30 patients, coronary endothelial function was assessed by acetylcholine test. Vessel response was calculated as a percent change of mean lumen diameter (MLD). Then patients were randomized into three groups: A (n = 11) placebo, B (n = 11) 80 mg atorvastatin, C (n = 8) 80 mg atorvastatin and 25 mg rofecoxib. After 7 days control test was performed. Recovery of coronary endothelial function was calculated as delta in percent changes of MLD between Days 1 and 7. On Day 1, percent change of MLD between baseline and maximum acetylcholine did not differentiate the groups: -20 ± 3.5% in A, -25 ± 3.9% in B and -26 ± 3.7% in C, P = .20. On Day 7, percentage changes in MLD were as follows: -21 ± 3.9% in A, -15 ± 3.0% in B and -10 ± 4.0% in C, P=.002. The delta in percentage change in MLD between Days 1 and 7 were as follows: -1% in A, + 10% in B and +16% in C, P = .02. In conclusion, short-term, anti-inflammatory therapy with high-dose atorvastatin and selective cyclooxygenase-2 inhibitor improves coronary endothelial function within 7 days in non-ST-segment elevation acute coronary syndrome patients.
目的是评估短期抗炎治疗对非ST段抬高型急性冠状动脉综合征患者冠状动脉内皮功能的影响。对30例患者通过乙酰胆碱试验评估冠状动脉内皮功能。血管反应以平均管腔直径（MLD）的变化百分比计算。然后将患者随机分为三组：A组（n = 11）服用安慰剂，B组（n = 11）服用80 mg阿托伐他汀，C组（n = 8）服用80 mg阿托伐他汀和25 mg罗非昔布。7天后进行对照试验。冠状动脉内皮功能的恢复以第1天和第7天MLD变化百分比的差值计算。在第1天，基线与最大乙酰胆碱作用下MLD的变化百分比在各组间无差异：A组为-20±3.5%，B组为-25±3.9%，C组为-26±3.7%，P = 0.20。在第7天，MLD的变化百分比情况如下：A组为-21±3.9%，B组为-15±3.0%，C组为-10±4.0%，P = 0.002。第1天和第7天MLD变化百分比的差值如下：A组为-1%，B组为+10%，C组为+16%，P = 0.02。总之，高剂量阿托伐他汀和选择性环氧化酶-2抑制剂的短期抗炎治疗可在7天内改善非ST段抬高型急性冠状动脉综合征患者的冠状动脉内皮功能。
