Effects Of Intensive Treatment Of Clopidogrel Or Atorvastatin On Efficacy Of Acute Myocardial Infarction In Elderly Patients

ObjectiveObjective Acute myocardial infarction is the most sever type of coronary heart disease,and is the main reason for the sudden cardiac death in clinical.It is usually manifested as chest distress,arrhythmia,shock and even heart failure.The purpose of this study is to analyze the effect of intensive treatment with clopidogrel or with atorvastatin in the elderly patients with acute myocardial infarction,to study the change of MACE events and the clinical side effects of drugs,and to explore the correlation of the levels of inflammatory factors,oxidation antioxidant protein,endothelial growth factor and transforming growth factor in the treatment of acute myocardial infarction,which provides reference for clinical treatment.MethodsA retrospective analysis of clinical data of elderly patients with acute myocardial infarction in our hospital from October 2015 to January 2009 were performed.There were 180 males and 120 females,aged from 66 to 78 years old,with an average of 72..9±5.1 years old.All of the patients meet the criteria for the diagnosis and treatment guidelines for the diagnosis and treatment of acute ST elevated myocardial infarction,which was established in 2015 by the cardiovascular branch of Chinese Medical Association.All patients were treated in accordance with guidelines for acute myocardial infarction(i.e.,aspirin,atorvastatin and clopidogrel,low molecular weight heparin),the observation,time was a month.115 patients in the standard group,dose:aspirin 100 mg,clopidogrel 75 mg,atorvastatin 20 mg,95 patients in the intensive clopidogrel therapy group,dose aspirin: 100 mg,clopidogrel 150 mg,atorvastatin 20 mg,90 patients in the intensive atorvastatin therapy group,dose: aspirin 100 mg,clopidogrel 75 mg,atorvastatin 40 mg.Comparative study of MACE and clinical drug side effects in each group were performed.Inflammatory factor,antioxidant enzyme,VEGF and TGFβ protein in serum before and after treatment were also analyzed.Results1.Compared with the standard group,the MACE event rate of intensive atorvastatin therapy group and intensive clopidogrel therapy group was significantly lower(P<0.05);but the MACE event rate between atorvastatin therapy group and clopidogrel therapy group was not statistically significant(P>0.05).2.Compared with the standard group,there was no significant difference in side effects such as bleeding,gastrointestinal reaction,granulocyte,myopathy and abnormal liver enzymes in intensive clopidogrel therapy group and intensive atorvastatin therapy group.(P > 0.05)3.Compared with the standard therapy group and intensive clopidogrel therapy group,serous inflammation factor level in elderly patients with acute myocardial infarction was significantly inhibited in intensive atorvastatin therapy group,and the difference was significant(P<0.05);but there was no significant difference between the standard therapy group and intensive clopidogrel therapy group,(P > 0.05).4.Compared with the standard therapy group,the level of MDA in serum was significantly inhibited in the intensive atorvastatin therapy group and clopidogrel therapy group,while proteins like SOD,CAT,and GSHPX was significantly high expressed in intensive clopidogrel therapy group and atorvastatin therapy group,there were statistical significance(P<0.05)5.Compared with the standard therapy group,the level of TGF-β and VEGF in serum was significantly inhibited in the intensive atorvastatin therapy group and clopidogrel therapy group,and the difference was statistically significant(P<0.05).ConclusionIntensive treatment of clopidogrel and atorvastatin in elderly patients with acute myocardial infarction produce protective effect,with no significantly increased adverse reaction rate,maybe its pharmacological mechanism lies in regulation of inflammatory reaction and oxidation-antioxidation level status in lesioned vasculars.