The Effect Of Different Doses Of Short-term Atorvastatin On TWEAK、CD163and Hs-CRP In Patients With Acute Coronary Syndrome During Perioperative Period Of PCI

[background]Coronary heart disease is a ischemic heart disease caused by atherosclerotic.In current years,AS is widely considered to be a chronic inflammatorydisease.Acute coronary syndrome,which is a severe type of coronary heartdisease (CHD),is a common serious cardiovascular disease. In coronary arteryatheromatous,plaque rupture or erosion, lead to complete or incompleteocclusive thrombosis,which is the pathological basis of a set of clinicalsyndrome.Atherosclerotic plaque instability is a common mechanism of ACS,the ACS patients tend to have vulnerable plaques. Compared to the stableplaques, vulnerable plaques have thin fibrous cap, big Lipid core, rich in bothinflammatory cells and tissue factor.With the growing understanding of atherosclerosis, the therapeutic drugsare also evolving, hydroxymethyl glutaryl coenzyme A reductase inhibitors (HM -CoA) has gradually become the main drug resistant to atherosclerosis. Recentstudies have found that early use of statins can reduce the incidence of theclinical adverse events in patients with acute coronary syndromes. There is littleclinical research about the effects of lipid lowering intervention onTWEAK,CD163and plasma hs-CRP in patients with acute coronarysyndrome.In this study,60patients with ACS are accept different doses ofatorvastatin during perioperative period of pereutaneous coronaryintervention(PCI), who are measured the concentration of plasma hs CRP,sTWEAK and sCD163and blood lipids and the changes of expression level inPeripheral blood mononuclear cells TWEAKmRNA, CD163mRNA before PCIand18-24hours after PCI, to explore the influence of the indexesmentioned-above on different dose atorvastatin intervention, and provide atheoretical basis for clinical treatment.With the growing understanding of atherosclerosis, the therapeutic drugsare also evolving, hydroxymethyl glutaryl coenzyme A reductase inhibitors (HM-CoA) has gradually become the main drug resistant to atherosclerosis. Recentstudies have found that early use of statins can reduce the incidence of theclinical adverse events in patients with acute coronary syndromes. There is littleclinical research about the effects of lipid lowering intervention onTWEAK,CD163and plasma hs-CRP in patients with acute coronarysyndrome.In this study,60patients with ACS are accept different doses ofatorvastatin during perioperative period of pereutaneous coronaryintervention(PCI), who are measured the concentration of plasma hs CRP,sTWEAK and sCD163and blood lipids and the changes of expression level inPeripheral blood mononuclear cells TWEAKmRNA, CD163mRNA before PCIand18-24hours after PCI, to explore the influence of the indexes mentioned-above on different dose atorvastatin intervention, and provide atheoretical basis for clinical treatment.[objective]To observe the influence on the concentration of plasma sTWEAK,sCD163and hs-CRP and the changes of expression level in Peripheral bloodmononuclear cells TWEAKmRNA, CD163mRNA in patients who are acceptdifferent doses of atorvaststin with ACS,to further explore inflammationinhibition mechanism and its effectiveness of short-term intensive treatment.[Methods]A total of60ACS patients were randomly divided into loading dose of statingroup(atorvastatin80mg/d2days before PCI,then40mg/d,n=30) andconventional dose of statin group(atorvastatin20mg/d,n=30).the concentrationof plasma sTWEAK,sCD163and hs-CRP and the changes of expression level inPeripheral blood mononuclear cells TWEAKmRNA, CD163mRNA weremeasured before PCI and18-24hours after PCI.[Results]1. No significant changes of lipid levels were observed in any group before andafter atorvastatin intervention；2. Compared to before,the levels of sTWEAK, sCD163and hs-CRP weredecreased markedly by80mg atorvastatin after PCI(P<0.05orP<0.01).the levelsof plasma hs-CRP,sTWEAK and sCD163did not decrease significantly by thetreatments of20mg atorvastatin；3. Compared with before, theTWEAKmRNA, CD163mRNA expressionin atorvastatn loading dose group were significantly lowerafter PCI(P <0.05); theTWEAKmRNA, CD163mRNA expression inconventional dose atorvastatin group decreased slightly after PCI, but no statistics differences.[Conclusion]1.TWEAK, CD163, hs-CRP are closely related to the occurrence anddevelopment of ACS, they play an important role in the ACS inflammatoryenvironment；2.TWEAK, CD163can be seen as important biological markers ofatherosclerosis in clinical, which have the potential value of early preventionand control of the ACS；3. Early intensive statin therapy in ACS patients reduces plasma sTWEAK,sCD163and Hs-CRP levels and TWEAKmRNA, CD163mRNA expression in adose-dependent manner；Anti-inflammatory effect of atorvastatin is independentof the lipid-lowering effect；early statin therapy can be of greater benefit inpatients with ACS.