Qin Yiran, Jin Siyi, Sun Xusen, Luo Rong, Liu Haibo
Department of Cardiology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Department of Hospital Infection Management, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Front Cardiovasc Med. 2025 Aug 22;12:1638967. doi: 10.3389/fcvm.2025.1638967. eCollection 2025.
Acute myocardial infarction in the elderly often leads to significant left ventricular structural remodeling, which adversely affects prognosis. This study aims to evaluate the effects of intensive rosuvastatin therapy on markers of ventricular remodeling and cardiac function following percutaneous coronary intervention (PCI) in elderly patients with ST-segment elevation myocardial infarction (STEMI).
This study enrolled 100 patients aged ≥60 years with STEMI who underwent emergency PCI. The patients were randomly assigned to either an intensive therapy group ( = 50), receiving rosuvastatin 20 mg/day, or a control group ( = 50), receiving 10 mg/day. Differences in lipid profiles, serum inflammatory markers, fibrosis indicators, and echocardiographic parameters were compared between the two groups before treatment and after 8 weeks of therapy.
After 8 weeks of treatment, the intensive group showed significantly reduced serum inflammatory levels compared to the control group, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) ( < 0.05). Markers of ventricular remodeling also improved in the intensive group, with lower levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), galectin-3, and matrix metalloproteinase-9 (MMP-9) compared to the control group ( < 0.05), while levels of tissue inhibitor of metalloproteinases-4 (TIMP-4) were significantly higher ( < 0.05). Additionally, after treatment, the intensive group demonstrated significantly higher levels of left ventricular ejection fraction (LVEF), stroke volume, and peak systolic velocity at the lateral mitral annulus (TDI s'-l) compared to the control group ( < 0.05). Conversely, the left ventricular end-systolic diameter (LVESD) and left ventricular end-systolic volume (LVESV) were significantly lower in the intensive group than in the control group ( < 0.05).
In elderly patients with STEMI, high-dose rosuvastatin demonstrates superior therapeutic efficacy compared to conventional-dose therapy in alleviating inflammatory responses, improving ventricular remodeling, and enhancing cardiac function.
[www.chictr.org.cn], identifier [ChiCTR2200066956].
老年人急性心肌梗死常导致显著的左心室结构重塑，对预后产生不利影响。本研究旨在评估强化瑞舒伐他汀治疗对老年ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）后心室重塑标志物和心功能的影响。
本研究纳入100例年龄≥60岁的STEMI患者，这些患者接受了急诊PCI。患者被随机分为强化治疗组（n = 50），接受瑞舒伐他汀20mg/天，或对照组（n = 50），接受10mg/天。比较两组治疗前及治疗8周后的血脂谱、血清炎症标志物、纤维化指标和超声心动图参数的差异。
治疗8周后，强化组血清炎症水平显著低于对照组，包括C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和细胞间黏附分子-1（ICAM-1）（P < 0.05）。强化组心室重塑标志物也有所改善，与对照组相比，N末端B型利钠肽原（NT-proBNP）、半乳糖凝集素-3和基质金属蛋白酶-9（MMP-9）水平较低（P < 0.05），而金属蛋白酶组织抑制剂-4（TIMP-4）水平显著较高（P < 0.05）。此外，治疗后，强化组左心室射血分数（LVEF）、每搏输出量和二尖瓣环外侧峰值收缩速度（TDI s'-l）显著高于对照组（P < 0.05）。相反，强化组左心室收缩末期内径（LVESD）和左心室收缩末期容积（LVESV）显著低于对照组（P < 0.05）。
在老年STEMI患者中，高剂量瑞舒伐他汀在减轻炎症反应、改善心室重塑和增强心功能方面显示出优于常规剂量治疗的疗效。
