Key Laboratory of Cardiovascular Remodeling and Function, Chinese Ministryof Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan, Shandong, China.
J Cardiovasc Pharmacol Ther. 2013 Jul;18(4):327-33. doi: 10.1177/1074248412474346. Epub 2013 Jan 29.
A high loading dose of atorvastatin has been confirmed to reduce postprocedural events in patients undergoing percutaneous coronary intervention (PCI). In this study, we sought to investigate the protective effects of rosuvastatin in patients with acute coronary syndromes (ACS) undergoing PCI and to determine the effect of rosuvastatin pretreatment on the postprocedural levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and monocyte chemotactic protein 1 (MCP-1).
A total of 125 patients with non-ST-segment elevation ACS were randomized to pretreatment with rosuvastatin (20 mg 2-4 hours before PCI [n = 62]) or placebo (n = 63). All the patients received subsequent long-term rosuvastatin treatment (10 mg/d). The main end point of the trial was the 30-day incidence of major adverse cardiac events (death, myocardial infarction, or unplanned revascularization). Plasma levels of hs-CRP, IL-6, and MCP-1 were detected before PCI and 6 hours, 24 hours, and 3 days after PCI.
The primary end point occurred in 8.1% of the patients in the rosuvastatin arm and 22.2% in the placebo arm (P < .01); this difference was entirely attributed to a reduced incidence of myocardial infarction (8.1% vs 22.2%; P < .01). The postprocedural elevation in creatine kinase-MB and troponin I was also significantly lower in the rosuvastatin group at 6 hours, 24 hours, and 3 days. Plasma levels of hs-CRP, IL-6, and MCP-1 increased significantly after PCI in both the rosuvastatin and control groups; however, the postprocedural elevations in hs-CRP and IL-6 levels were significantly lower in the rosuvastatin group than the control group.
A single, high dose (20 mg) of rosuvastatin prior to PCI reduces postprocedural myocardial injury in patients with ACS, with a concomitant attenuation of the postprocedural increase in hs-CRP and IL-6 levels.
阿托伐他汀高负荷剂量已被证实可降低经皮冠状动脉介入治疗（PCI）后的事件发生率。本研究旨在探讨瑞舒伐他汀对行 PCI 的急性冠状动脉综合征（ACS）患者的保护作用，并确定瑞舒伐他汀预处理对术后高敏 C 反应蛋白（hs-CRP）、白细胞介素 6（IL-6）和单核细胞趋化蛋白 1（MCP-1）水平的影响。
共纳入 125 例非 ST 段抬高型 ACS 患者，随机分为瑞舒伐他汀预处理组（PCI 前 2-4 小时给予瑞舒伐他汀 20mg[n = 62]）或安慰剂组（n = 63）。所有患者随后均接受长期瑞舒伐他汀治疗（10mg/d）。试验的主要终点为 30 天内主要不良心脏事件（死亡、心肌梗死或计划外血运重建）的发生率。于 PCI 前及 PCI 后 6 小时、24 小时和 3 天检测 hs-CRP、IL-6 和 MCP-1 血浆水平。
瑞舒伐他汀组和安慰剂组的主要终点事件发生率分别为 8.1%和 22.2%（P <.01）；这一差异完全归因于心肌梗死发生率的降低（8.1%比 22.2%；P <.01）。瑞舒伐他汀组在 PCI 后 6 小时、24 小时和 3 天肌酸激酶同工酶-MB 和肌钙蛋白 I 的升高也显著降低。瑞舒伐他汀组和对照组在 PCI 后 hs-CRP、IL-6 和 MCP-1 水平均显著升高，但瑞舒伐他汀组 hs-CRP 和 IL-6 水平的升高幅度显著低于对照组。
PCI 前单次给予高剂量（20mg）瑞舒伐他汀可减轻 ACS 患者的术后心肌损伤，并伴随 hs-CRP 和 IL-6 水平的术后升高幅度降低。
