Xie Wenchao, Li Ping, Wang Zhengdong, Chen Jian, Lin Zhihai, Liang Xiangwen, Mo Yingxi
Department of Cardiology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, Guangxi, China.
Cardiovasc Ther. 2014 Dec;32(6):276-82. doi: 10.1111/1755-5922.12098.
The beneficial effect of rosuvastatin against percutaneous coronary intervention (PCI) related procedural myocardial injury has been determined mostly in patients with acute coronary syndromes (ACS). However, the detailed therapeutic mechanism has not been well studied.
Patients with ACS receiving PCI (n = 159) were randomized to control group (placebo treatment) or to rosuvastatin group (20 mg 12 h before PCI, and a further 20 mg 2 h preprocedure dose). Levels of INF-γ, TNF-α, IL-6, miR-155/SHIP-1, and CD4(+)FoxP3(+)Treg in peripheral blood were detected before PCI and 24 h after PCI. Clinical data of these patients were also collected in this prospective study.
Compared with placebo, rosuvastatin treatment significantly reduced the incidence of periprocedural myocardial infarction (PMI) and levels of cardiac troponin I (cTnI) associated with decreased relative expression of serum miR-155, levels of inflammatory cytokines (INF-γ, TNF-α, and IL-6), increased SHIP-1 expression and CD4(+)FoxP3(+)Treg percentage values (P < 0.05). In addition, patients with rosuvastatin pretreatment also reduced incidence of 30 days major adverse cardiac events (MACE) compared to the patients with placebo treatment (16 patients vs. 28 patients, P = 0.038).
Our study suggests that high loading dose rosuvastatin pretreatment may reduce the incidence of cardiovascular events and levels of inflammatory markers in patients with ACS receiving PCI, which may be explained at least in part, by mechanism involving suppression of miR-155/SHIP-1 signaling pathway.
瑞舒伐他汀对经皮冠状动脉介入治疗（PCI）相关程序性心肌损伤的有益作用大多在急性冠状动脉综合征（ACS）患者中得到确定。然而，详细的治疗机制尚未得到充分研究。
接受PCI的ACS患者（n = 159）被随机分为对照组（安慰剂治疗）或瑞舒伐他汀组（PCI前12小时服用20 mg，术前2小时再服用20 mg）。在PCI前和PCI后24小时检测外周血中INF-γ、TNF-α、IL-6、miR-155/SHIP-1和CD4(+)FoxP3(+)Treg的水平。在这项前瞻性研究中还收集了这些患者的临床数据。
与安慰剂相比，瑞舒伐他汀治疗显著降低了围手术期心肌梗死（PMI）的发生率和心肌肌钙蛋白I（cTnI）水平，同时血清miR-155的相对表达降低，炎症细胞因子（INF-γ、TNF-α和IL-6）水平降低，SHIP-1表达增加以及CD4(+)FoxP3(+)Treg百分比值增加（P < 0.05）。此外，与接受安慰剂治疗的患者相比，瑞舒伐他汀预处理的患者30天主要不良心脏事件（MACE）的发生率也有所降低（16例患者对28例患者，P = 0.038）。
我们的研究表明，高负荷剂量瑞舒伐他汀预处理可能降低接受PCI的ACS患者的心血管事件发生率和炎症标志物水平，这至少部分可以通过抑制miR-155/SHIP-1信号通路的机制来解释。
