阿托伐他汀与瑞舒伐他汀对冠心病患者经皮冠状动脉介入治疗术后再发率及相关危险因素的比较。

Comparison between Atorvastatin and Rosuvastatin on Secondary Percutaneous Coronary Intervention Rate and the Risk Factors in Patients with Coronary Heart Disease.

机构信息

Department of Cardiology, Shanghai Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200065, China.

Institute of Clinical Epidemiology and Evidence-based Medicine, Tongji University School of Medicine, Shanghai, 200092, China.

出版信息

Curr Drug Metab. 2020;21(10):818-828. doi: 10.2174/1389200221666200310110410.

DOI:10.2174/1389200221666200310110410

PMID:32156233

Abstract

OBJECTIVE

The aim is to compare atorvastatin versus rosuvastatin on secondary percutaneous coronary intervention (PCI) rate and explore risk factors in coronary heart disease (CHD) patients.

METHODS

A cohort study with 283 CHD subjects was launched from 2011 to 2015. Cox proportional hazards regression model, Receiver Operating Characteristic (ROC) and nomogram were used to compare the effect of atorvastatin and rosuvastatin on secondary PCI rate and disease risk factors. Even why the two statins had different effects based on gene expression profile analysis has been explored.

RESULTS

Gene FFA (Freely fatty acid), AST (Aspartate Transaminase) and ALT (Alanine transaminase) showed the statistical difference between the four statin groups (P<0.05). In the AA group (Continuous Atorvastatin usage), albumin was a risk factor (Hazard Ratio (HR):1.076, 95%CI (1.001, 1.162), p<0.05). In the AR group (Start with Atorvastatin usage, then change to Rosuvastatin usage), ApoA was a protective factor (HR:0.004, 95%CI (0.001, 0.665), p<0.05). GLB (Galactosidase Beta) was a risk factor (HR:1.262, 95%CI (1.010, 1.576), p<0.05). In RR group (Continuous Rosuvastatin usage), ApoE was a protective factor (HR:0.943, 95%CI (0.890, 1.000), <0.05). ALT was a risk factor (HR:1.030, 95%CI (1.000, 1.060), p<0.05).

CONCLUSION

Patients in the RA group had the lowest secondary PCI rate. ALT was a risk factor in the RR group. Gene Gpt (Glutamic Pyruvic Transaminase) encoded for one subtype of ALT had a significantly different expression in different statin groups.

摘要

目的

比较阿托伐他汀与瑞舒伐他汀对冠心病患者二次经皮冠状动脉介入治疗（PCI）率的影响，并探讨相关危险因素。

方法

2011 年至 2015 年期间开展了一项包含 283 例冠心病患者的队列研究。采用 Cox 比例风险回归模型、受试者工作特征（ROC）曲线和列线图比较阿托伐他汀和瑞舒伐他汀对二次 PCI 率和疾病危险因素的影响。并基于基因表达谱分析探讨了两种他汀类药物作用效果不同的原因。

结果

FFA（游离脂肪酸）、AST（天门冬氨酸氨基转移酶）和 ALT（丙氨酸氨基转移酶）基因在四组他汀类药物中存在统计学差异（P<0.05）。在 AA 组（连续使用阿托伐他汀）中，白蛋白是一个危险因素（风险比（HR）：1.076，95%置信区间（1.001，1.162），p<0.05）。在 AR 组（开始使用阿托伐他汀，然后改为瑞舒伐他汀）中，ApoA 是一个保护因素（HR：0.004，95%置信区间（0.001，0.665），p<0.05）。GLB（β-半乳糖苷酶）是一个危险因素（HR：1.262，95%置信区间（1.010，1.576），p<0.05）。在 RR 组（连续使用瑞舒伐他汀）中，ApoE 是一个保护因素（HR：0.943，95%置信区间（0.890，1.000），<0.05）。ALT 是一个危险因素（HR：1.030，95%置信区间（1.000，1.060），p<0.05）。