Sinan Umit Yasar, Keskin Meric Bengisu, Bursa Nurbanu, Moumin Gkiozde, Kaya Aysem, Arat Ozkan Alev
Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Türkiye.
Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Türkiye.
Front Cardiovasc Med. 2024 Aug 20;11:1435989. doi: 10.3389/fcvm.2024.1435989. eCollection 2024.
High-dose statin therapy before percutaneous coronary intervention (PCI) is thought to reduce the occurrence of Peri-procedural Myocardial Infarction (PPMI), which is associated with increased mortality and prolonged hospitalization, especially in statin naïve patients. This study aims to investigate the effect of rosuvastatin loading dose on PPMI and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing elective PCI, considering their statin use.
One hundred sixty-five patients with stable coronary artery disease (CAD) without heart failure (HF) or chronic kidney disease (CKD) were included in the study. They were divided into two groups: patients already on statin treatment (:126) and statin naive patients (:39). Both groups were randomly assigned to high-dose (40 mg) rosuvastatin (:86) or a non- loading dose group (:79). The primary endpoint was the incidence of PPMI, and the secondary endpoint was MACCE.
The mean age of study population was 59 ± 9.4 years with 77% being male ( = 127). The median follow-up (FU) time was 368 day. Thirty patients were diagnosed with PPMI after PCI (19 in the high-dose group and 11 in the no-loading-dose group). Meanwhile, less than half of study population (77 patients, 46.7%) had complex lesion type (B2, C) and 88 of those (53.3%) had simple lesion type (A, B1). PPMI was observed more frequently in statin-naive patients (23%) than in statin users (17%), although the difference was not statistically significant. Only two patients (1.2%) experienced MACCE during the FU period. One of these patients, who had a type C lesion, belonged to group A2 and underwent Target Vessel Revascularization (TVR) on the 391st day. The other patient, with a type B1 lesion, was in group A1 and was hospitalized due to Acute Coronary Syndrome (ACS) on the 40th day of FU.
Pre-procedural administration of high dose rosuvastatin in patients with stable coronary artery disease did not decrease PPMI, independent of chronic statin use.
经皮冠状动脉介入治疗（PCI）前使用大剂量他汀类药物治疗被认为可降低围手术期心肌梗死（PPMI）的发生率，PPMI与死亡率增加和住院时间延长相关，尤其是在未使用过他汀类药物的患者中。本研究旨在探讨瑞舒伐他汀负荷剂量对接受择期PCI患者的PPMI及主要不良心脑血管事件（MACCE）的影响，并考虑其他汀类药物使用情况。
165例无心力衰竭（HF）或慢性肾脏病（CKD）的稳定型冠状动脉疾病（CAD）患者纳入本研究。他们被分为两组：已接受他汀类药物治疗的患者（n = 126）和未使用过他汀类药物的患者（n = 39）。两组均随机分为大剂量（40 mg）瑞舒伐他汀组（n = 86）或非负荷剂量组（n = 79）。主要终点为PPMI的发生率，次要终点为MACCE。
研究人群的平均年龄为59±9.4岁，男性占77%（n = 127）。中位随访（FU）时间为368天。30例患者在PCI术后被诊断为PPMI（大剂量组19例，非负荷剂量组11例）。同时，不到一半的研究人群（77例，46.7%）为复杂病变类型（B2、C），其中88例（53.3%）为简单病变类型（A、B1）。未使用过他汀类药物的患者中PPMI的发生率（23%）高于使用他汀类药物的患者（17%），尽管差异无统计学意义。在随访期间，只有2例患者（1.2%）发生了MACCE。其中1例患有C型病变的患者属于A2组，在第391天接受了靶血管血运重建（TVR）。另1例患有B1型病变的患者属于A1组，在随访第40天时因急性冠状动脉综合征（ACS）住院。
在稳定型冠状动脉疾病患者中，术前给予大剂量瑞舒伐他汀并不能降低PPMI的发生率，与是否长期使用他汀类药物无关。
