Effect Of Intensive Statins On Levels Of PTX3 And Hs-CRP In Patients With Acute Coronary Syndrome After PCI

Objective: To explore the sensitivity of inflammatory factor PTX3 in early forecast of the coronary artery damage in ACS patients accepted PCI,and to observe the influence of different dose of pitavastatin and atorvastatin on the inflammatory factors,providing theory basis for management of patients with ACS and assessment of the disease prognosis.Methods: 121 patients diagnosed as ACS in cardiovascular department ? of Cangzhou Central Hospital were selected from January 2015 to October 2015,and divided into 3 groups randomly: Conventional pitavastatin group(38 cases)took pitavastatin 2 mg before sleep.Conventional atorvastatin group(40 cases)took atorvastatin 20 mg before sleep.Intensive pitavastatin group(43 cases)took pitavastatin 4 mg before sleep on preoperative and postoperative day,then maintained 2 mg later.We measured the levels of PTX3 and hs-CRP at baseline and 24h?72h after PCI,and record the major adverse cardiac events(MACE)in 121 patients during 6 months,including cardiac death,target vascular remodeling and nonfatal myocardial infarction.Results: 1.The basic clinical data of 121 patients before PCI showed no statistical difference(P>0.05);2.There was no statistical difference in levels of hs-CRP among 3 groups before PCI(P>0.05);comparison among 3 groups,the levels of hs-CRP at 24h?72h after PCI was of no statistical difference in each group(P>0.05);compared with the preoperative,the levels of hs-CRP at 24h?72h after PCI among 3 groups was of no statistical difference(P>0.05);3.The levels of PTX3 before PCI among 3 groups was of no statistical difference(P>0.05);and at 24 h after PCI was higher than baseline,but the levels of PTX3 at 72 h is decreased compared with 24 h,though the concentrations was still higher than baseline(P<0.05);comparison between the 2 conventional dose groups,the levels of PTX3 at 24h?72h after PCI was of no statistical difference(P >0.05),but the levels of PTX3 in intensive pitavastatin group at 24 h ? 72 h after PCI was lower than conventional groups(P <0.05);4.There was no cardiac death within 6 months after PCI in 3 groups.In conventional pitavastatin group,there were 0 MI cases happening,and 1 patient accepted target vessel remodeling;in conventional atorvastatin group,there was 0 MI cases happening,and 1 patient accepted target vessel remodeling;in intensive pitavastatin group,there was 0 MACE happening;The total incidence of MACE during 6 months was of no statistical difference among 3 groups(P>0.05).Conclusions:1.The sensitivity of PTX3 in early prediction of the blood vessel damage in ACS patients accepted PCI is better than hs-CRP.2.For ACS patients who accept PCI,PCI itself will damage the vascular wall,cause inflammation and increase the levels of PTX3.3.There was no significant statistical difference between conventional pitavastatin and atorvastatin therapy in reducing inflammation.Intensive pitavastatin therapy is better than conventional pitavastatin and atorvastatin therapy in reducig inflammation4.Using intensive pitavastatin therapy at perioperative PCI period did not reduce the incidence of MACE within 6 months.