Xia Jinggang, Qu Yang, Yin Chunlin, Xu Dong
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
Cardiology. 2015;131(1):30-7. doi: 10.1159/000371872. Epub 2015 Mar 27.
We explored whether preoperative rosuvastatin could protect the cardiac health of patients with coronary artery disease undergoing emergency, noncardiac surgery.
We randomized 550 noncardiac emergency surgery patients with stable coronary artery disease on long-term statin therapy to treatment with and without preoperative rosuvastatin. All patients received rosuvastatin after surgery. We evaluated the incidence of myocardial necrosis and major adverse cardiovascular and cerebrovascular events (MACCE) 30 days and 6 months after surgery.
Creatinine kinase-myocardial band (CK-MB) isoform elevations occurred less frequently 12 and 24 h after noncardiac emergency surgery in the experimental group than in the control group (p = 0.029). After surgery, the incidence of MACCE was also lower in the experimental group than in the control group (p = 0.019). The difference was mainly due to the incidence of perioperative myocardial infarction (p = 0.029). Multivariable analysis found that rosuvastatin reload reduced the incidence of MACCE 52% 6 months after surgery (p = 0.03).
Preoperative rosuvastatin reload therapy decreases the incidence of myocardial necrosis and MACCE after noncardiac emergency surgery in patients with stable coronary artery disease on long-term statin therapy.
我们探讨了术前使用瑞舒伐他汀是否能保护接受急诊非心脏手术的冠心病患者的心脏健康。
我们将550例长期接受他汀类药物治疗的稳定型冠心病非心脏急诊手术患者随机分为术前使用和不使用瑞舒伐他汀治疗两组。所有患者术后均接受瑞舒伐他汀治疗。我们评估了术后30天和6个月时心肌坏死及主要不良心血管和脑血管事件（MACCE）的发生率。
与对照组相比，非心脏急诊手术后12小时和24小时，实验组中肌酸激酶心肌型（CK-MB）同工酶升高的发生率更低（p = 0.029）。术后，实验组中MACCE的发生率也低于对照组（p = 0.019）。差异主要归因于围手术期心肌梗死的发生率（p = 0.029）。多变量分析发现，术后6个月时瑞舒伐他汀再负荷治疗使MACCE的发生率降低了52%（p = 0.03）。
对于长期接受他汀类药物治疗的稳定型冠心病患者，术前瑞舒伐他汀再负荷治疗可降低非心脏急诊手术后心肌坏死及MACCE的发生率。
