| Background: Stains which have known as(3-hyroxy-3-methylglutaryl coenzyme A(HMG.Co A) reductase inhibitors have got more attention in the assignment of primary and secondary prevention of coronary artery diseases,as well as they have become a substantial component in the treatment of coronary artery disease. Statins were initially used to reduce total plasma cholesterol as well as to control blood lipid profile,but recent studies have found that statins have carried out an effects on clinical outcome in addition to lowering lipids.The non-lipid lowering effect of statins was called pleiotropic effect, including improve endothelial function, diminish oxidative stress, reduce platelet adhesion, promote atherosclerotic plaque stability, participate in regulation of the blood clotting cascade,direct anti-inflammation and cardioprotection. However, the mechanism underlying this protective effect has not been fully elucidated.Objectives: The aim of this study was to compare the effects of different atorvastatin loading doses before PCI in coronary artery disease(CAD) patients on PCI-related inflammatory factors and myocardial injury.Methods: A total of 221 patients underwent elective PCI were randomly assigned into three groups, group A(20 mg atorvastatin 12 h before PCI; n=70), group B(40 mg atorvastatin 12 h before PCI; n=75) and group C(80 mg atorvastatin 12 h before PCI; n=76). Changes in homocysteine, highly sensitive C-reactive protein, neutrophil and cardiac Troponin I levels wereanalyzedbefore and after PCI among the three groups, correlation of elevated levels of homocysteine(HCY) with neutrophil count, hs-CRP, and c Tn I also were statistically analyzed,along with the effects of different doses of atorvastatin on PCI-related inflammation and the incidence of perioperative MI, which defined as post-PCI c Tn I levels greater than 3 ×99th percentile of the upper reference limit. Serum samples before and after PCI were collected and placed in-80? refrigerator, HCY was examined by ELISA.all of the variables data computed by SPSS statistical software.Results:(1) No significant differences were noted in the baseline clinical data, the coronary angiographic parameters, and medications used before PCI in either group.(2) After PCI Blood levels of homocysteine, highly sensitive C-reactive protein and neutrophils were significantly higher than their levels before PCI in the three groups, changes of their levels before and after PCI in group C(80mg) was statistically lower than 40 mg and 20 mg groups,[?HCY levels(4.65±2.13 vs. 2.43±1.08 vs. 1.27±0.40) ?mol/L, P<0.001; ?hs-CRP(6.32±2.52 vs. 5.26±2.76 vs. 3.50±1.98) mg/L, P<0.001; and ?neutrophil(3.28±0.45 vs.2.64±0.43 vs. 1.78±0.41)106/ml, P<0.001], also the elevated homocysteine levels was significantly correlated with the changes of ?neutrophil count(r=0.711, P<0. 001),?hs-CRP concentrations(R=0.228, P<0.01), and post-PCI c Tn I(R=0.183, P<0.05).(3) The incidence of Post-PCI MI at group C(80mg atorvastatin loading dose) was the lowest,and at group A(20mg atorvastatin loading dose) was the highest(0.96±0.39 vs.0.86±0.32 vs.0.75±0.31; P<0.05).Conclusion : The results of the current study demonstrated that acute administration of atorvastatin loading pre-PCI was well acceptable and had beneficial anti- inflammatory and myocardial protective effects in patients with CAD. |
PDF Full Text Request