Cardiovascular Medicine Department, Yongchuan Hospital Affiliated to Chongqing Medical University, Chongqing, China.
Drug Dev Res. 2020 Aug;81(5):551-556. doi: 10.1002/ddr.21651. Epub 2020 Mar 6.
To conduct a randomized double-blind prospective study to investigate effect of different doses of atorvastatin, rosuvastatin, and simvastatin on elderly patients with ST-elevation AMI after PCI.
One hundred and ninety-two AMI patients over 60 years old who underwent PCI were randomly divided into six groups: the low atorvastatin group, high atorvastatin group; low rosuvastatin group; high rosuvastatin group; low simvastatin group; high simvastatin group. Demographic data and clinical information as well as coronary angiography parameters were recorded. Plasma levels of CK-MB, BNP, ALT, and TnI were measured at 12 hr, 24 hr, and 1 week after PCI. Major cardiovascular events (MACE) were recorded and analyzed using Kaplan-Meier (K-M) curve.
No significant differences were observed in angiographic and procedural characteristics. In all high dose groups, all levels of CK-MB, BNP, ALT, and TnI were significantly lower. However, after 1 week of PCI, only CK-MB, BNP, and TnI showed significant difference between high and low dose groups. Patients in high dose groups had significantly lower rates for surgical or percutaneous intervention, recurrence of angina, and rehospitalization. K-M curve analysis also showed cumulative incidence freedom time of overall MACE in high dose groups was significantly longer. No significant differences were found among different drugs with the same doses.
Patients with higher doses had lower level of CK-MB, BNP, ALT, and TnI and lower occurrence of MACE after PCI.
开展一项随机、双盲、前瞻性研究，以探讨不同剂量阿托伐他汀、瑞舒伐他汀和辛伐他汀对行 PCI 的老年 ST 段抬高型 AMI 患者的影响。
将 192 例行 PCI 的年龄大于 60 岁的 AMI 患者随机分为六组：低剂量阿托伐他汀组、高剂量阿托伐他汀组；低剂量瑞舒伐他汀组、高剂量瑞舒伐他汀组；低剂量辛伐他汀组、高剂量辛伐他汀组。记录人口统计学数据和临床信息以及冠状动脉造影参数。于 PCI 后 12 h、24 h 和 1 周测定 CK-MB、BNP、ALT 和 TnI 水平。采用 Kaplan-Meier（K-M）曲线记录并分析主要心血管不良事件（MACE）。
各组间的血管造影和手术特征无显著差异。在所有高剂量组中，CK-MB、BNP、ALT 和 TnI 的各水平均显著降低。然而，PCI 后 1 周时，仅 CK-MB、BNP 和 TnI 在高、低剂量组间存在显著差异。高剂量组患者接受手术或经皮介入治疗、心绞痛复发和再住院的比例显著较低。K-M 曲线分析还显示，高剂量组的总体 MACE 累积无事件时间明显延长。相同剂量的不同药物之间未见显著差异。
PCI 后高剂量组患者的 CK-MB、BNP、ALT 和 TnI 水平较低，MACE 发生率较低。
