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高强度或中等强度瑞舒伐他汀对经皮冠状动脉介入治疗后1年主要不良心血管事件的影响。

Effects of High- or Moderate-intensity Rosuvastatin on 1-year Major Adverse Cardiovascular Events Post-percutaneous Coronary Intervention.

作者信息

Chehrevar Morteza, Vafa Reza Golchin, Rahmani Mohammadhossein, Parizi Mohammadjavad Mehdizadeh, Ahmadi Amin, Zamiri Bardia, Heydarzadeh Reza, Montaseri Mohammad, Hosseini Seyed Ali, Kojuri Javad

机构信息

Cardiology Department, Shiraz University of Medical Sciences Shiraz, Iran.

Professor Kojuri Cardiology Clinic Shiraz, Iran.

出版信息

Interv Cardiol. 2022 Nov 29;17:e20. doi: 10.15420/icr.2022.13. eCollection 2022 Jan.

Abstract

Although statins decrease mortality in coronary artery disease, the effect of high-dose statins and duration of therapy post-percutaneous coronary intervention (PCI) is not well addressed. To determine the effective dose of statin to prevent major adverse cardiovascular events (MACEs), such as acute coronary syndrome, stroke, myocardial infarction, revascularisation and cardiac death, after PCI in patients with chronic coronary syndrome. In this randomised, double-blind clinical trial, all chronic coronary syndrome patients with a recent history of PCI were randomly divided into two groups after 1 month of high-dose rosuvastatin therapy. Over the next year, the first group received rosuvastatin 5 mg daily (moderate intensity), while the second received rosuvastatin 40 mg daily (high intensity). Participants were evaluated in terms of high-sensitivity C-reactive protein and MACEs. The 582 eligible patients were divided into group 1 (n=295) and group 2 (n=287). There was no significant difference between the two groups in terms of sex, age, hypertension, diabetes, smoking, previous history of PCI or history of coronary artery bypass grafting (p>0.05). There were no statistically significant differences in MACE and high-sensitivity C-reactive protein after 1 year between the two groups (p=0.66). The high-dose group had lower LDL levels. However, given the lack of association between high-intensity statins and MACEs in the first year after PCI among chronic coronary syndrome patients, the use of moderate-intensity statins may be as effective as high-intensity statins, and treatment based on LDL targets may suffice.

摘要

尽管他汀类药物可降低冠心病死亡率,但大剂量他汀类药物的效果以及经皮冠状动脉介入治疗(PCI)后治疗持续时间尚未得到充分研究。为了确定他汀类药物预防慢性冠状动脉综合征患者PCI后主要不良心血管事件(MACE)(如急性冠状动脉综合征、中风、心肌梗死、血运重建和心源性死亡)的有效剂量。在这项随机、双盲临床试验中,所有近期有PCI病史的慢性冠状动脉综合征患者在接受1个月的大剂量瑞舒伐他汀治疗后被随机分为两组。在接下来的一年里,第一组患者每天服用5毫克瑞舒伐他汀(中等强度),而第二组患者每天服用40毫克瑞舒伐他汀(高强度)。根据高敏C反应蛋白和MACE对参与者进行评估。582名符合条件的患者被分为第1组(n = 295)和第2组(n = 287)。两组在性别、年龄、高血压、糖尿病、吸烟、既往PCI史或冠状动脉搭桥术史方面无显著差异(p>0.05)。两组在1年后的MACE和高敏C反应蛋白方面无统计学显著差异(p = 0.66)。高剂量组的低密度脂蛋白水平较低。然而,鉴于在慢性冠状动脉综合征患者PCI后的第一年,高强度他汀类药物与MACE之间缺乏关联,使用中等强度他汀类药物可能与高强度他汀类药物一样有效,基于低密度脂蛋白目标的治疗可能就足够了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7685/9987507/62ecef6573bb/icr-17-e20-g001.jpg

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