Preprocedural statin administration can reduce thrombotic reaction after Stent implantation
Preprocedural statin administration can reduce thrombotic reaction after Stent implantation
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DOI：
10.1253/circj.72.232
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发表时间：
2008-02-01
影响因子：
3.3
通讯作者：
Yamada, Yoshio
中科院分区：
文献类型：
--
作者：
Nishino, Masami;Hoshida, Shiro;Yamada, Yoshio
背景：已有报道称，支架置入会导致急性炎症和血小板沉积（急性期反应）以及平滑肌细胞（SMC）增殖（慢性期反应）。其他研究表明，他汀类药物治疗可以减少血栓形成作为一种多效性效应。本研究进行检查是否术前他汀类药物治疗可以减少支架植入后血栓形成反应，通过使用支架内再狭窄（ISR）tissue.Methods和结果研究组包括45例连续患者（稳定型心绞痛）ISR谁接受定向冠状动脉粥样斑块切除术（DCA）。根据组织学检查结果将患者分为两组：ISR组织中含有血栓和SMC的患者（T组）和ISR组织中仅含有SMC的患者（S组）。在DCA之前，评估血清标志物，包括高敏C反应蛋白（hs-CRP）、脂蛋白（a）、纤溶酶原激活物抑制剂-1（派-1）、纤维蛋白原、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、空腹血糖和血红蛋白A1 c。还评价了术前药物，包括他汀类药物。T组hs-CRP、派-1水平显著高于S组，他汀类药物使用率显著低于S组。其他因素无显著差异。多因素分析显示，术前他汀类药物的使用和派-1水平是影响支架术后血栓形成的重要独立变量。结论术前他汀类药物的应用，与派-1的参与有关，可减少支架术后的血栓形成。
Background It has been reported that stent deployment results in acute inflammation and platelet deposition as an acute phase reaction and smooth muscle cell (SMC) proliferation as a chronic phase reaction. Other studies have shown that statin therapy can reduce thrombosis as a pleiotropic effect. The present study was undertaken to examine whether preprocedural statin therapy can reduce the thrombotic reaction after stent implantation by using in-stent restenosis (ISR) tissue.Methods and Results The study group consisted of 45 consecutive patients (stable angina) with ISR who underwent directional coronary atherectomy (DCA). According to the histological findings, the patients were divided into 2 groups: those whose ISR tissue included thrombus and SMC (T group), and those whose ISR tissue included only SMC (S group). Just before DCA, serum markers were evaluated, including high-sensitivity C-reactive protein (hs-CRP), lipoprotein (a), plasminogen activator inhibitor-1 (PAI-1), fibrinogen, total cholesterol, triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, and hemoglobin A1c. Preprocedural medications, including statins, were also evaluated. The values for hs-CRP and PAI-1 in the T group were significantly higher than those in the S group, and the rate of statin use in the T group was significantly lower than that in the S group. There were no significant differences in any of the other factors. Multivariate analysis revealed that preprocedural statin use and the PAI-1 level were significant independent variables affecting the histological findings.Conclusion Preprocedural statins, associated with the involvement of PAI-1, can reduce the thrombotic reaction after stent implantation.