Analysis Of Related Factors Of Intensive Statin Therapy In Patients With Acute Coronary Syndrome Undergoing Emergency PCI

Objective:Through the study of emergency patients before PCI received intensive statin therapy on patients with acute coronary syndrome and endothelial cycle particles in blood(EMPs) and(or) supersensitivity C reactive protein(hs-CRP) level of influence,To discuss the effect of intensive statin therapy on inflammatory response of endothelial cells and to observe the safety of intensive statin therapy and the occurrence of adverse cardiovascular events.Methods:From the Department of Cardiology of Affiliated Hospital of Yan’an University hospital 100 ACS patients during emergency PCI surgery patients,Randomly divided into two groups, strengthening group: 50 patients, emergency PCI preoperative atorvastatin calcium tablets(80mg), insist on take 3 months after operation(40mg); control group: 50 patients, emergency PCI preoperative atorvastatin calcium tablets(20mg), insist on take 3 months after surgery(20mg);Venous blood of two groups patients were collected when they were on admission, after PCI immediately and 24 h after PCI respectively. Plasma endothelial microparticles(EMPs) levels by flow cytometry, serum super sensitivity C-reactive protein(hs-CRP) by enzyme-linked immunosorbent assay nephelometry,Which analyze the change between the two groups in plasma levels of EMPs and serum hs-CRP level between.At the same time to observe the blood PCI of two groups of patients in coronary TIMI and Within 3 months after statin drug side effects and overall MACE event rate.Results:1.Plasma EMPs levels at various time points between the two groups of patients:by comparing EMPs levels of two groups on admission, P=0.525>0.05, the result showed that there was no significant difference;Immediately after inter-comparison: When comparing two groups of patients hospitalized EMPs plasma levels were increased(P <0.05), and the strengthening of the EMPs plasma levels lower than conventional group;Comparison of postoperative 24 h and postoperative instantly between: comparing two groups of patients immediately after the plasma levels of EMPs compared with the immediate postoperative decreased(P <0.05), but also to strengthen the group decreased more obvious.2.Plasma hs-CRP levels at various time points between the two groups of patients: Comparison of serum hs-CRP levels when patients were admitted to hospital,P=0.569>0.05, the result showed that there was no significant difference;Immediately after inter-comparison: When comparing two groups of patients hospitalized hs-CRP plasma levels were increased(P <0.05), and the strengthening of the hs-CRP plasma levels lower than conventional group;Comparison of postoperative 24 h and postoperative instantly between: comparing two groups of patients immediately after the plasma levels of hs-CRP compared with the immediate postoperative decreased(P <0.05), but also to strengthen the group decreased more obvious.3.Relationship between plasma levels of EMPs and serum hs-CRP levels between the two groups of patients:According to the results of the correlation analysis between plasma levels of EMPs and serum hs-CRP levels correlated poorly(0 <r <0.4, P> 0.05).4.Strengthen the group and conventional coronary surgery patients PCI TIMI flow improved compared to the situation: 47 cases were effective in 50 cases of the Strengthen group(94%) and 40 cases were effective in 50 cases of the conventional group(80%);Emergency surgery were compared coronary TIMI flow to improve the situation, P = 0.037(P <0.05), showed that the difference was statistically significant, It is indicating that preoperative oral intensive statin drugs can improve coronary blood flow emergency PCI surgery, reduce no-reflow.5. Safety Evaluation: After 3 months of intensive group and the conventional group taking statins probability of occurrence of side effects in comparison: P = 0.712> 0.05, showed no significant difference,there was no difference that Strengthen the group and the the conventional group statin side effects between the two groups.The two groups overall incidence of MACE events Within 3 months:P = 0.036 <0.05, the difference was statistically significant, it is considered preoperative intensive statin therapy reduces the incidence of MACE in patients recently.Conclusion:1.Plasma EMPs and serum hs-CRP can reflect acute coronary syndrome inflammation and injury in emergency PCI coronary endothelial cells;2.Intensive statin reduces emergency patients after PCI EMPs plasma and serum hs-CRP levels, improve coronary blood flow during and reduce cardiovascular events in patients within 3 months;3.There was a poor correlation between the plasma EMPs and serum hs-CRP levels.4.There was no significant difference between intensive statin therapy and conventional statin in safety.