The Safety Studies For Elderly Patients In PCI Perioperative Period With Atorvastatin Sequential Therapy

Objective:The purpose of this study is to compare the safety of atorvastatin sequential therapy between the elderly NSTEMI (>75years) who receive the atrovastatin sequential therapy and without the sequential therapy in the PCI perioperative period.Methods:112elderly patients with NSTEMI treated with PCI in the First Affiliated Hospital of Dalian Medical University between July to December2012and were divided into two groups according to with or withuot atorvastatin sequential therapy.48patients were divided in Elderly with sequential therapy group (>75years, ST group), and64patients in Elderly with sequential therapy (>75years, N-ST group). In the ST group,80mg atorvastatin was administered a day before PCI, and thereafter40mg/d for a month.In the N-ST group,20mg/d atorvastatin was given during PCI and1month follow-up. The hepatic adverse effects and the extensions of in hospital periods by the atrovastatin treatment and MACE (Major adverse cardiovascular events) were observed and all of the patients were followed-up for one month.Results:The basis of two groups of patients with clinical data, including age, sex, smoking, hypertension, diabetes, body mass index (bmi), LDL-c, TC, transaminase, bilirubin and creatinine, CRP, EF value had no significant statistical difference (P<0.05). The patients in the ST group compared with the N-ST group, LDL-c, TC were significantly lower (74±3.7vs.93±4.1), but the postoperative1day transaminase increased significantly (213±6.8vs.46±5.3) with statistically significant (P<0.05). After one month follow-up, LDL-c, TC is still significantly decreased with statistically significant (P<0.05) in the ST group, and the transaminase was no statistical difference (P<0.05) between them. At the follow-up3months,6months, and9months, there were no evident difference between the two groups in blood lipid and there is no statistical difference (P<0.05). There were no difference in the MACE events between them in the1months (P<0.05), although at9months follow-up it was showed reduced MACE in ST group but no statistical difference compared with N-ST group(P<0.05).Conclusion:For the elderly patients with STEMI at the PCI perioperative period, sequential lipid-lowering the effect of sequential lipid-lowering therapy is obvious, but its safety (liver enzyme increased and prolonged hospitalization) compared with the none-sequential treatment group was statistically difference. Although Atrovastatin sequential treatment group follow-up results indicate the incidence of MACE events is decreased, but it was no difference compared with the none-sequential treatment group. Therefore, for elderly NSTEMI patients, It should be careful using statin sequential treatment.