摘要
目的：探讨经皮冠状动脉介入（PCI）术前,负荷剂量阿托伐他汀的强化治疗,对高龄老年冠心病患者预后的影响。方法：入选年龄在70-82岁择期行PCI的患者共300例,随机分为常规治疗组和强化治疗组,观察术后心肌标志物及高敏C反应蛋白（hs-CRP）的水平变化及术后1个月和12个月主要不良心脏事件（MACE,包括心源性死亡、心肌梗死和靶血管血运重建）的发生率。结果：常规治疗组术后24 h c TNI和hs-CRP高于强化治疗组（P=0.04和P=0.01）。强化他汀治疗组PCI术后与PCI相关心肌梗死发生率明显低于常规治疗组（12.1%vs.21.8%,P=0.047）。强化他汀治疗组中12个月时LDL≤1.8 mmol/L比率更高（10.1%vs.4.0%,P=0.04）。12个月时MACE事件发生率强化治疗组低于常规治疗组（9.4%vs.17.2%,P=0.046）。结论：高龄冠心病患者择期PCI术前强化阿托伐他汀钙80 mg/d可以显著减少与PCI相关的心肌梗死,并且安全性良好。
Objective： High dose statin pretreatment before percutaneous coronary intervention（ PCI） is associated with a reduced incidence of adverse events and periprocedural myocardial infarction（ MI）. However,the effects of statin pretreatment in elderly patients have not been evaluated. Methods： Consecutive 300 elderly patients with coronary heart disease who underwent PCI were randomly assigned to receive pretreatment high dose of Atorvastatin（ 80 mg） before PCI（ Atorvastatin group,n = 149,AG） or to receive chronic statin therapy without high dose before PCI（ control group,n = 151,CG）. The incidence of major adverse cardiac events（ MACE）,including cardiac death,non-fatal MI and any ischemia-driven revascularization,was assessed after1 month and 12 months. Results： The patients in 80 mg statin group showed significantly lower levels of c TNI and hs- CRP at 24 h after PCI than those in 20 mg statin group（ P〈0. 05）,and had also a significantly lower incidence of total MACE within 12 months after PCI（ 9. 4% vs. 17. 2%,P = 0. 047） resulting primarily from significantly reduced myocardial infarction associated with PCI（ 12. 1% vs. 21. 8%,P = 0. 046）. The adverse drug reactions were comparable between the two groups（ P〉0. 05）. Conclusion： High-dose statin pretreatment improves procedural and long term clinical outcomes and has good safety in elderly patients with coronary heart disease.
出处
《心肺血管病杂志》
2016年第3期170-174,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
北京市保健局课题:高龄冠心病PCI患者强化他汀治疗的有效性和安全性研究(京13-12)
关键词
冠状动脉介入治疗
他汀药物
高龄
Statins treatment
Percutaneous coronary intervention
Eldly patients
