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Minerva Medica 2019 April;110(2):101-6

DOI: 10.23736/S0026-4806.18.05633-1


lingua: Inglese

The effects of atorvastatin on interventional therapy in patients with acute myocardial infarction

Kai WANG 1, Lili CHEN 1, Li LIU 2, Yikai CUI 3, Xiaohu ZHANG 3, Jun JIANG 1

1 Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; 2 General Family Medicine, Hangzhou Xiacheng District Community Health Service Center, Hangzhou, China; 3 General Family Medicine, Hangzhou Shangcheng District Community Health Service Center, Hangzhou, China

BACKGROUND: The aim of this study was to analyze the changes of interleukin-6 (IL-6), C-reactive protein (CRP), blood lipids and myocardial indexes after treatment of patients with acute myocardial infarction (AMI) with intensive atorvastatin and interventional therapy, and its clinical significance.
METHODS: A total of 78 patients diagnosed with AMI in our hospital from March 2016 to February 2017 were selected and divided into treatment group (N.=39) and control group (N.=39). Patients in treatment group were treated with intensive atorvastatin based on conventional therapy before and after percutaneous coronary intervention (PCI), while those in control group were treated with conventional therapy before and after PCI. The levels of serum IL-6, CRP, blood lipids (total cholesterol [TC], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) and myocardial enzyme indexes (troponin T [TnT] and creatine kinase-MB [CK-MB]) at different time points were detected. The correlations among serum CRP, TC, and TnT in treatment group before treatment were detected using the linear regression analysis, and changes in serum inflammatory factors, blood lipids and myocardial enzyme indexes in treatment group before and after treatment were analyzed.
RESULTS: There were no statistically significant differences in demographics and clinical data between treatment group and controls (P>0.05). There were no significant differences, either, in levels of serum IL-6 and CRP before treatment between treatment group and control group, but they were decreased after treatment, and the curative effect in treatment group was significantly superior to that in control group. The differences were statistically significant (P<0.05). There were no significant differences in serum TC, TG, HDL-C and LDL-C levels before treatment between the two study groups. TC, TG and LDL-C were significantly decreased and HDL-C was significantly increased after treatment compared to before treatment. TnT and CK-MB were significantly increased at 24 hours after treatment (P<0.05). At 1 week, TnT was still higher, whereas CK-MB has returned to normal; at 2 weeks, they were both decreased. The curative effect in the treatment group was significantly superior to that in control group. CRP (r=0.793, P<0.001) and TC (r=0.668, P<0.001) were found to be positively correlated with TnT. The levels of serum inflammatory factors and blood lipids in the treatment group before treatment and at 24 hours, 1 week, and 2 weeks showed a decreasing trend, and TnT was increased at first, and then decreased.
CONCLUSIONS: The application of intensive atorvastatin for AMI patients, especially before PCI, has high safety, which can effectively reduce levels of serum inflammatory factors and blood lipids, protect myocardial cells after PCI and avoid injury.

KEY WORDS: Atorvastatin calcium - Myocardial infarction - Interleukin-6 - C-reactive protein

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