The Influence Of Percutaneous Coronary Intervention(PCI)Myocardial Injury Of Sodium Tanshinone ⅡA Sulfonate In Patients With Acute Coronary Syndrome

Object i veExplored sodium tanshinone IIA sulfonate injection(STS)on patients with acute coronary syndrome(ACS)recent incidence of major adverse cardiac events,the influence of percutaneous coronary intervention(PCI)myocardial injury.MethodsThe study enrolled in 72 patients with acute coronary syndrome,included on unstable angina pectoris and Non-ST segment elevation myocardial infarction,from October 2014 to January 2016.These patients were randomly assigned either to the treatment group(n=35)or to the control group(n=37).The contorl group received standard treatment of the ACS guideline of western medicine,and the treatment group received STS 80mg/d+ 0.9%normal saline or 5%glucose solution 250ml five days(two days before coronary angiography and three days after PCI).In addtion to standard treatment of western medicine.We examined the troponin level for assessing perioperative myocardial injury or infarct in baseline,8 hours,24 hours and three days after PCI.We are follow up by telephone atfer the patients discharge hospital for one month,and recording the incidence of major adverse cardiac clinical events(MACE)in 30 days,which consist of cardiac death,non-fatal myocardial infarction,stent thrombosis,documented unstable angina requiring revascularization(bypass surgery or repeat PCI),as the primary endpoint.The follow-up is maintained 1 month until the last enrolled patient is beyond.The second endpoint is to obsevred the change of the plasma CRP level after and before treatment.ResultsAll of patients in this study,71 cases finised testing in hospital,one cases falled off on treatment group,48 cases accepted percutaneous coronary intervention,66.7%.We had 68 cases finished the follow-up in 1 month via telephone,and 4 was lost(3 cases in treatment and 1 cases in control group).It have a good balance and homogeneity between treatment and control group.There is no significantly deffrence in MACE(p>0.05),17 cases(50.5%)in treatment group and 19 cases(51.4%)in control group.The same result to PMI,incidence rate of PMI in treatment group is 47.1%vs 43.2%in group treatment.In each group have one cardiac death,one revascularization.There are no significant difference(p>0.05).But in our trial the MACE case in the control group is more than the treatment group.On the subgroup analyzing of troponin level,cTnI levels continuous downward trend after 24 hours of PCI in treatment group,and there is a statistically significant before and after treatment(p<0.05).In control group,cTnI levels continuous upward trend after 24 hours of PCI,there is a statistically significant before and after treatment(p<0.05).Thus STS can significantly reduce patient’ s cTnI levels.The second end point show both group can reduced the CRP level after treatment(p<0.05),but there is no diffrence between treatment group and control group(p>0.05).ConclutionSodium tanshinone ⅡA sulfonate can not improved the recent adverse cardiovascular events and perioperative myocardial infarction patients with acute coronary syndrome.But tanshinone injection can significantly reduce postoperative cTnI level after postoperative,we speculated that STS can improve perioperative myocardial injury,having a protective effect on the myocardium.