STEMI急诊PCI术前负荷剂量阿托伐他汀对心肌血流灌注及血清sCD40L水平的影响

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Abstract Objective To study the effects of a loading-dose atorvastatin on the coronary blood pefusion and serum sCD40L after primary PCI in STEMI patients. Methods STEMI patients who were prepared for primary PCI were randomly divided into three groups: group A (received atorvastatin 80 mg loading dose before PCI then followed by 40 mg daily for one month and a maintenance dose of 20 mg daily thereafter), group B (received atorvastatin 40 mg daily after PCI for one month and a maintenance dose of 20 mg daily thereafter) and group C (received atorvastatin 20 mg daily after PCI). TIMI flow grade and corrected TIMI frame count (cTFC) after PCI were recorded and compared between the three groups. In addition, the serum sCD40L was measured at admission and 24 h, 7 d, 30 d after PCI. Adverse reactions were monitored during 30 d follow-up. Results The cTFC in group A (25.44±12.07) was significamtly lower than that in group B (30.98±12.09) or that in group C (33.49±14.56) (P<0.05); The percentages of TIMI grade 3 were 91.7% (44/48),88.4% (38/43),86.7% (39/45) in group A, group B and group C respectively, and no significant difference was found among the three groups. The levels of serum sCD40L at 24 h and 7 d after PCI in group A [(16.18±4.52) ng/ml, (3.92±1.44) ng/ml]were significantly lower than those in group B [(18.25±5.02) ng/ml, (4.63±1.68) ng/ml] and group C [(18.66±4.17) ng/ml,(4.68±1.51) ng/ml]. But the levels of sCD40L in the three groups did not reach statistical differences at 30 d after PCI. No severe adverse reactions were observed during study period. Conclusions For STEMI patients who undergo primary PCI, a loading-dose of atorvastatin before PCI can reduce serum sCD40L level, improve immediate coronary blood perfusion and does not increase the incidences of adverse events.

Key words： ST segment elevated myocardial infarction atorvastatin sCD40L corrected TIMI frame count statin safety

Received: 10 April 2014

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2014/V25/I9/878

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