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ω-3补充剂对慢性肾脏病患者冠状动脉支架置入术后高敏C反应蛋白水平及30天主要不良心脏事件的影响:一项随机临床研究

Impact of Omega-3 Supplementation on High Sensitive C-Reactive Protein Level and 30-Day Major Adverse Cardiac Events After the Implementation of Coronary Stent in Patients with Chronic Kidney Disease: A Randomized Clinical Study.

作者信息

Foroughinia Farzaneh, Movahed Nouri Bahram, Kojuri Javad, Ostovan Mohammad Ali

机构信息

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Adv Pharm Bull. 2018 Aug;8(3):471-478. doi: 10.15171/apb.2018.055. Epub 2018 Aug 29.

Abstract

Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adverse effects of percutaneous coronary intervention (PCI). In addition, the role of elevated high sensitive C-reactive protein (hs-CRP) in the prediction of adverse cardiac outcomes after coronary stent implantation has already been shown. Therefore, in this study, we aimed to evaluate the effect of omega-3 supplementation on hs-CRP and 30-day major adverse cardiac events (MACE) in patients with CKD undergoing elective PCI. In this randomized trial, 80 CKD patients who were candidates for elective PCI, were randomly assigned to two groups; the first group received a single dose of omega-3 (2500 mg, 12 h before PCI) as well as the standard drug regimen of PCI and the second group received placebo plus the standard therapy (325 mg loading dose of aspirin, 600 mg loading dose of clopidogrel, and weight-adjusted intravenous heparin). Hs-CRP levels were measured at baseline and 24 h after the intervention as a primary endpoint. The secondary endpoint was the incidence of MACE over a 30-day period after PCI. Omega-3 did not significantly decrease post-PCI serum level of hs-CRP; however, the overall 30-day MACE was significantly lower in the omega-3 group compared to the control group (p=0.05). Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; hence, omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI. The evaluation of the effect of omega-3 on long-term MACE is recommended for future studies.

摘要

研究表明,慢性肾脏病(CKD)患者更容易受到经皮冠状动脉介入治疗(PCI)不良反应的影响。此外,高敏C反应蛋白(hs-CRP)升高在预测冠状动脉支架植入术后不良心脏结局中的作用已经得到证实。因此,在本研究中,我们旨在评估补充ω-3对接受择期PCI的CKD患者hs-CRP和30天主要不良心脏事件(MACE)的影响。在这项随机试验中,80名符合择期PCI条件的CKD患者被随机分为两组;第一组在PCI前12小时接受单剂量ω-3(2500毫克)以及PCI的标准药物治疗方案,第二组接受安慰剂加标准治疗(325毫克负荷剂量阿司匹林、600毫克负荷剂量氯吡格雷和根据体重调整的静脉注射肝素)。将基线时和干预后24小时的hs-CRP水平作为主要终点进行测量。次要终点是PCI后30天内MACE的发生率。ω-3并没有显著降低PCI后血清hs-CRP水平;然而,ω-3组的30天总体MACE明显低于对照组(p=0.05)。我们的结果显示了补充ω-3对降低30天MACE的积极作用;因此,ω-3可被视为PCI前使用的标准药物治疗方案的有效辅助治疗。建议未来的研究评估ω-3对长期MACE的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb22/6156476/b4abc22d7677/apb-8-471-g001.jpg

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