Hu Xianqing, Cheng Jian, Li Chunjian
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
Department of Cardiology, Jinhua Municipal Central Hospital, Jinhua, China.
Eur J Clin Pharmacol. 2018 Jan;74(1):29-35. doi: 10.1007/s00228-017-2338-8. Epub 2017 Sep 30.
BACKGROUND/AIMS: Early and intensive atorvastatin treatment can decrease nonsustained ventricular tachycardia (nsVT) in patients with ST-segment elevation myocardial infarction (STEMI). The objective of this study was to compare the effects of hydrophilic rosuvastatin and lipophilic atorvastatin on nsVT in STEMI patients treated with primary percutaneous coronary intervention (PCI).
The data from a cohort of patients undergoing primary PCI at Jinhua Municipal Central Hospital from January 1, 2013 through June 30, 2016 were analyzed. The patients were divided into the rosuvastatin group and the atorvastatin group based on which kind of statins that they had received. The endpoint of the study was the occurrence of nsVT on either electrocardiogram monitoring or Holter monitoring.
A total of 301 patients were enrolled in the study (rosuvastatin group: n = 103; atorvastatin group: n = 198). The baseline and procedural characteristics were similar between the two groups, except that total ischemic time in the rosuvastatin group was markedly longer than that in the atorvastatin group (8 (5-16) h vs. 6 (4-12) h; P = 0.001). The administration of rosuvastatin was significantly associated with lower occurrence of nsVT than that of atorvastatin (9.71 vs. 19.70%; P = 0.026). Multivariable logistic regression analysis suggested that the independent predictors of nsVT included rosuvastatin (odds ratio (OR) 0.397, 95% confidence interval (CI) 0.176-0.894), current smoking (OR 2.307, 95% CI 1.011-5.262), and left ventricular ejection fraction (LVEF) (OR 1.060, 95% CI 1.023-1.098).
The effects of rosuvastatin on nsVT might be better than that of atorvastatin in STEMI patients undergoing primary PCI.
背景/目的：早期强化阿托伐他汀治疗可降低ST段抬高型心肌梗死（STEMI）患者的非持续性室性心动过速（nsVT）。本研究的目的是比较亲水性瑞舒伐他汀和亲脂性阿托伐他汀对接受直接经皮冠状动脉介入治疗（PCI）的STEMI患者nsVT的影响。
分析了2013年1月1日至2016年6月30日在金华市中心医院接受直接PCI的一组患者的数据。根据患者接受的他汀类药物种类，将患者分为瑞舒伐他汀组和阿托伐他汀组。研究终点是心电图监测或动态心电图监测中nsVT的发生情况。
共有301例患者纳入研究（瑞舒伐他汀组：n = 103；阿托伐他汀组：n = 198）。两组的基线和手术特征相似，但瑞舒伐他汀组的总缺血时间明显长于阿托伐他汀组（8（5 - 16）小时对6（4 - 12）小时；P = 0.001）。与阿托伐他汀相比，瑞舒伐他汀的使用与nsVT发生率较低显著相关（9.71%对19.70%；P = 0.026）。多变量逻辑回归分析表明，nsVT的独立预测因素包括瑞舒伐他汀（比值比（OR）0.397，95%置信区间（CI）0.176 - 0.894）、当前吸烟（OR 2.307，95%CI 1.011 - 5.262）和左心室射血分数（LVEF）（OR
