The Effect Of Different Hypolipidemic Regimens On Endocan Level During Peri-operation In Patients With NSTE-ACS Undergoing PCI And Safety

Objective: Observe effect of statin and statin combined with ezetimibe on Endocan level during peri-operation in patients with NST-ACS undergoing PCI,to explore whether high intensity statin or statin combined with ezetimibe can improve endothelial dysfunction during peri-operation and whether high intensity statin or statin combined with ezetimibe is safe.Method: Patients in First Ward of Cardiovascular Department of the first affiliated hospital of China Medical University from September,2017 to July,2018 were enrolled.Finally 175 eligible patients with NSTE-ACS undergoing PCI were included in our study according the including and excluding criteria.Patients were divided into four groups according different lipid-lowering therapies: atorvastatin 20mg;atorvastatin 20 mg combined ezetimibe 10mg;atorvastatin 40mg;atorvastatin 40 mg combined ezetimibe 10 mg.We observe change of serum Endocan,LDL-C,major adverse of cardiovascular events(MACE)and statin-related adverse reaction in hospitalization.Result:1.All baseline characteristics,biochemistry before PCI,and procedural characteristics in four groups is similar(P>0.05).2.Compared with Endocan before PCI,Endocan after PCI were obviously increased in four groups(P<0.001).Multiple comparison analysis of Endocan after PCI showed that compared with atorvastatin 20 mg group,atorvastatin 40 mg group can alleviate the rise of Endocan level after PCI(27.62±2.78 ng/ml vs.26.38±2.34 ng/ml,P<0.05).Compared with atorvastatin 20 mg combined with ezetimibe 10 mg group,atorvastatin 40 mg combined with ezetimibe 10 mg group can alleviate the rise of Endocan level after PCI(26.15±2.52 ng/ml vs.25.10±2.24 ng/ml,P<0.05).Besides,compared with atorvastatin 20 mg group,atorvastatin 20 mg combined with ezetimibe 10 mg group can alleviate the rise of Endocan level after PCI(27.62±2.78ng/ml vs.26.15±2.52ng/ml,P<0.05).Compared with atorvastatin 40 mg group,atorvastatin 40 mg combined with ezetimibe 10 mg group can alleviate the rise of Endocan level after PCI(26.38±2.34 ng/ml vs.25.10±2.24 ng/ml,P<0.05).But the Endocan level after PCI is similar in atorvastatin 20 mg combined ezetimibe 10 mg group and atorvastatin 40 mg group(26.15±2.52 ng/ml vs.26.38±2.34 ng/ml,P>0.05).3.The change of LDL-C during peri-operation has no significant difference in four groups(P>0.05)?4.The change of ALT and CK during peri-operation has no significant difference in four groups(P>0.05).5.MACE in hospitalization in four groups has no significant difference in four groups(P>0.05).Conclusion: Compared moderate intensity statin,high intensity statin can reduce the rise of Endocan after PCI.Adding ezetimibe to statin can decrease rise of Endocan after PCI compared with statin monotherapy.That suggested that high intensity statin or addition of ezetimibe to statin can improve endothelial function during peri-operation but not the LDL-C level.Intensive lipid-lowering is safe in NST-ACS during peri-operation.