Assessment of therapeutic effects of statin on cardiac sympathetic nerve activity after reperfusion therapy in patients with first ST-segment elevation myocardial infarction and normal low-density lipoprotein cholesterol
Assessment of therapeutic effects of statin on cardiac sympathetic nerve activity after reperfusion therapy in patients with first ST-segment elevation myocardial infarction and normal low-density lipoprotein cholesterol
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DOI：
10.1007/s12350-019-01857-y
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发表时间：
2021-08-01
影响因子：
2.4
通讯作者：
Kurabayashi, Masahiko
中科院分区：
文献类型：
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作者：
Takahashi, Shinya;Kasama, Shu;Kurabayashi, Masahiko
背景他汀类药物治疗可降低心脏病患者的心脏交感神经活动（CSNA）增强，并减少冠心病患者的不良心脏事件。方法回顾性分析我院收治的首次ST段抬高型心肌梗死（STEMI）患者，低密度脂蛋白胆固醇< 120 mg/dL，入院3周后行I-123-间碘苄胍（MIBG）冠状动脉造影。选择了60例直接冠状动脉成形术后的STEMI患者，并使用倾向评分匹配来比较接受强效他汀类药物治疗的患者（n = 30）和未接受强效他汀类药物治疗的患者（n = 30）。治疗前及治疗后3周分别测定超声心动图左室（LV）参数及血浆Ⅲ型前胶原氨基末端肽（PIIINP）。结果两组患者的年龄、性别、危险因素、罪犯冠状动脉、血清肌酸磷酸激酶峰值浓度及再通时间均相似。然而，他汀类药物组显示出显著较低的延迟总缺损评分和I-123-MIBG造影评估的洗脱率（22.4 +/- 8.1 vs. 29.6 +/- 10.5; P < 0.01，30.4 +/- 8.9% vs. 40.1 +/- 11.4%; P < 0.005）和更高的延迟心脏/纵隔计数比（2.17 +/- 0.38 vs. 1.96 +/- 0.30，P < 0.05）。此外，他汀类药物组的LV参数和PIIINP变化程度优于非他汀类药物组。结论他汀类药物可改善首次STEMI患者再灌注治疗后的CSNA。
Background Statin treatment reduces enhanced cardiac sympathetic nerve activity (CSNA) in patients with heart disease, and reduces adverse cardiac events in patients with coronary artery disease. Methods We retrospectively evaluated the first ST-segment elevation myocardial infarction (STEMI) patients and low-density lipoprotein cholesterol < 120 mg/dL in our database who underwent I-123-metaiodobenzylguanidine (MIBG) scintigraphy 3 weeks after admission. Sixty STEMI patients after primary coronary angioplasty were selected, and used propensity score matching to compare patients treated with strong statin (n = 30), and those who did not (n = 30). Moreover, echocardiographic left ventricular (LV) parameters were determined, and plasma procollagen type III amino terminal peptide (PIIINP) was also measured before and 3 weeks after treatment. Results Following primary angioplasty, age, gender, risk factors, culprit coronary artery, peak serum creatine phosphokinase concentration, and recanalization time were similar in the two groups. However, the statin group showed significantly lower delayed total defect score and washout rate evaluated by I-123-MIBG scintigraphy (22.4 +/- 8.1 vs. 29.6 +/- 10.5; P < 0.01, and 30.4 +/- 8.9% vs. 40.1 +/- 11.4%; P < 0.005, respectively) and higher delayed heart/mediastinum count ratio (2.17 +/- 0.38 vs. 1.96 +/- 0.30, P < 0.05) compared with the non-statin group. Moreover, the degree of change in LV parameters and PIIINP was more favorable in the statin group than in the non-statin group. Conclusions Administration of statin improves CSNA after reperfusion therapy in patients with first STEMI.