The Effects Of Short-term Prognosis Of Rosuvastatin Intensive Therapy On Patients With Acute Coronary Syndrome After PCI

Objective: The study on acute coronary syndrome patients withpreoperative percutaneous coronary intervention(PCI) were given atorvastatinand rosuvastatin treatment, through the comparison of the effects of differentstatins on short-term prognosis of patients with PCI, is to provide a clinicalevidence for PCI patients with preoperative statin choice.Methods: Our hospital elective PCI patients with ACS150cases (male98cases,52females) were randomly divided into control group which wasatorvastatin calcium conventional treatment group (AG-20mg50cases),rosuvastatin calcium conventional treatment group (RG-10mg50cases),rosuvastatin calcium intensive therapy group (RG-20mg50cases).The atorvastatin calcium conventional treatment group, preoperative andpostoperative atorvastatin calcium standard dose (20mg/night,oral)treatment. The rosuvastatin calcium conventional treatment group,preoperative and postoperative rosuvastatin calcium standard dose (10mg/night,oral) treatment. The rosuvastatin calcium intensive therapy grouppreoperative and postoperative rosuvastatin calcium standard dose (20mg/night,oral) treatment.①The primary end point was incidence ofperiprocedural myocardial injury in each group,which was assessed byanalysis of creatine kinase-MB(CK-MB)and cardiac troponin I (cTnI)beforePCI, at6h and the next morning after PCI. If the first blood sample wasfound higher than the normal value, a second blood sample would be drawnevery8hr until a downward trend was observed. For patients with two ormore blood samples drawn.The peak CK-MB and cTnI level was>upper limitof normal was periprocedural myocardial injury.②The secondary end pointwas the assessment of major adverse cardiac events(MACE)[cardiacdeath,all-myocardial infarction (MI), stroke, and target vessel revascularization (TVR)] after PCI30-day. Myocardial infarction includesperiprocedural MI，which is the rate of periprocedural rise of cTnI level>3upper limit of normal.③Using high-sensitivity C-reactive protein(hs-CRP) asa marker of inflammatory injury, to observe the changes of hs-CRP of thepatients in each group after PCI6h and24h.④T o observe the changes ofblood lipid of the patients in each group after PCI30D. The blood lipidinclude the total cholesterol(TC),triglycerides(TG) and low densitylipoprotein(LDL) levels.Results:1There were no significant differences in clinical characteristics(age, sex, hypertension, diabetes, smoking history, Angiotensin-ConvertingEnzyme Inhibitors(ACEI)/Angiotensin Receptor Blocker(ARB) applicationand so on)between the there groups before PCI(p>0.05).2Compared with properative,three groups of blood lipids (TC, TG andLDL) lower leve after PCI30d. Between the three groups, there was nosignificant differences in atorvastatin and rosuvastatin conventional treatmentgroup（p>0.05), rosuvastatin intensive therapy group was better than theatorvastatin and rosuvastatin conventional treatment group（p<0.05).3Using hs-CRP as a marker of inflammatory injury, there was nosignificant difference between the three groups before PCI24h（4.14±0.69VS4.29±0.61VS4.17±0.63, p=0.501）. The follow-up24h hs-CRP,there was nosignificant difference between the atorvastatin and rosuvastatin conventionaltreatment group(6.23±1.15VS5.93±0.85, p=0.299),but there is a significantdifference between the two conventional treatment group and rosuvastatinintensive therapy group（6.23±1.15VS4.60±0.60, p=0.000;5.93±0.85VS4.60±0.60,p=0.000）.4Using cTnI and CK-MB as a marker of myocardial injury, after PCI,incidence of periprocedural myocardial injury，there was no significantdifferences in atorvastatin and rosuvastatin conventional treatment group（cTnI:28%VS24%, p=0.648;CK-MB:26%VS20%, p=0.476）, but thereis a significant difference between the two conventional treatment group and rosuvastatin intensive therapy group（（cTnI:28%VS8%,p=0.009,24%VS8%,p=0.029;CK-MB:26%VS6%,p=0.006,20%VS6%, p=0.037）.5There was no death, stroke, target vessel revascularization and otheradverse cardiovascular events between the three groups after PCI30d. cTnI>3times the normal high limit as periprocedural myocardial infarction, therewas no significant differences in atorvastatin and rosuvastatin conventionaltreatment group（cTnI:18%VS16%, p=0.790）, but there was a significantdifference between the two conventional treatment group and rosuvastatinintensive therapy group （cTnI:18%VS2%, p=0.008;16%VS2%p=0.036）.Conclusion: PCI can damage the vascular wall, cause inflammation,increased to increase hs-CRP and serum markers of myocardial injury whichis the level of cTnI CK-MB. Early use of statins may reduce inflammatoryresponse and myocardial injury after PCI, so as to improve the prognosis ofthe patients. In reducing blood lipids, there was no significant differencesatorvastatin and rosuvastatin conventional treatment group, rosuvastatinintensive therapy was better than atorvastatin and rosuvastatin conventionaltreatment group. In reducing inflammatory response and myocardial injury,there was no significant differences atorvastatin and rosuvastatin conventionaltreatment group,rosuvastatin intensive therapy is better than atorvastatin androsuvastatin conventional treatment group. Evaluation of the prognosis ofpatients after PCI, rosuvastatin intensive therapy is better than atorvastatinand rosuvastatin conventional treatment group.