| ObjectiveComparison of the influence on the platelet aggregation of clopidogrel combined with differentmetabolic pathways statins atorvastatin or rosuvastatin in patients with Emergency PCI.MethodsFrom May2013to November2013, there were80patients with acute myocardial infarctiontreated with emergency PCI enrolled into this study. They were randomly divided into theatorvastatin group (group A40cases); rosuvastatin group (group B40cases).All patientschewed Aspirin300mg and received clopidogrel300mg before emergency PCI. Patients ingroup A received atorvastatin40mg/qd and Patients in group B received rosuvastatin20mg/qdafter PCI. All patients received dual antiplatelet therapy with aspirin100mg/qd and clopidogrel75mg/qd. The platelet aggregation was measured with whole blood impedanceaggregometry(WBIA）on the7days and30days. We observed the major adverse cardiovascularevents (MACE): all-cause mortality, recurrent angina, recurrent myocardial infarction, targetvessel revascularization and deterioration of cardiac function in patients after30days. Wecompared the difference of platelet aggregation and MACE rate between the two groups. Testingthe alanine aminotransferase, creatinine, total cholesterol and low-density lipoprotein in the first24hours and30days after PCI and recording the quantity of patients who had adverse drugreaction such as muscle pain, headache, and so on after30days to evaluate the effects oflipid-lowering and drug safety.Result1. Data compared between the two groups of patients in age, gender ratio, past history, biochemical detectionvalue and concomitant medications was not statistically significant.2. Comparing the platelet aggregation between the two groups of patients. After PCI, on the7thday and30thday, we compared the platelet aggregation of group A with group B. The result were（3.09±3.99Ωvs3.79±4.20Ω t=-0.76P=0.45）and（2.59±3.48Ω vs2.99±4.20Ω t=-0.53P=0.6）. The platelet aggregation of group B and group A had no statistical difference（P>0.05）. 3. MACE after30days. There were9patients (22.5%) with recurrent angina,3patients (7.5%)with deterioration of heart function in group A and5patients (12.5%) with recurrent angina,4patients (10%) with deterioration of heart function in group B. In addition there were no patientswho had recurrent myocardial infarction or target vessel revascularization or all-cause mortalityafter30days. There was no significant difference between the two groups of patients in adverseevents and overall MACE (P>0.05).4. The effect of lipid-lowering. After30days the level of patients’ TC and LDL-C was decreasedsignificantly. And the difference was statistically significant (P <0.05). According to the level ofLDL-C <1.8mmol/l or LDL-C decreased by50%compared to the admission, we compared thepercentage of patients who’s level of LDL-C reached the goal in the two groups（55%vs62.5%χ2=0.46P=0.49）.5. Drug adverse reaction. There was no significant difference in the baseline of patients’ ALT andSCr in the two groups. After30days, the level of patients’ ALT and SCr were no significantdifference compared to the admission（P>0.05). There was one patients (2.5%) with ALT>3ULNin group A and0in group B. The level of this patient’ ALT returned to the normal after twoweeks when he stopped to take statins. There was no patient with CK>5ULN or statin-relatedmyopathy.ConclusionsThe influence on the antiplatelet fuction of clopidogrel combined with atorvastatin40mg/qd orrosuvastatin20mg/qd were similar in patients with Emergency PCI when they received intensivestatin therapy. |
