Patients with Stable Coronary Artery Disease Receiving Chronic Statin Treatment Who Are Undergoing Noncardiac Emergency Surgery Benefit from Acute Atorvastatin Reload
Patients with Stable Coronary Artery Disease Receiving Chronic Statin Treatment Who Are Undergoing Noncardiac Emergency Surgery Benefit from Acute Atorvastatin Reload
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接受慢性他汀类药物治疗且正在接受非心脏紧急手术的稳定型冠状动脉疾病患者可从急性阿托伐他汀再装药中获益
DOI：
10.1159/000362593
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发表时间：
2014-05
期刊：
影响因子：
1.9
通讯作者：
Liu, Xiuhua
中科院分区：
文献类型：
--
作者：
Xia, Jinggang;Qu, Yang;Shen, Hong;Liu, Xiuhua
目的：本研究旨在探讨接受慢性他汀类药物治疗且接受非心脏急诊手术的稳定型冠状动脉疾病（CAD）患者是否能从急性阿托伐他汀再负荷中获益。方法：共有 500 名稳定 CAD 且在非心脏急诊手术前定期服用他汀类药物的患者被随机分配接受阿托伐他汀再负荷治疗 (n = 250) 或安慰剂 (n = 250)。此后所有患者均接受阿托伐他汀治疗。主要终点是 30 天主要不良心脏事件 (MACE) 的发生率。次要终点是住院期间心房颤动（AF）的发生率和住院时间。结果：阿托伐他汀再装治疗组和安慰剂组的主要终点发生率分别为 2.4% 和 8% (p = 0.0088)。阿托伐他汀再装治疗组患者住院期间房颤的发生率为 6.8%，安慰剂组为 17%（p = 0.0003）。与安慰剂组相比，阿托伐他汀再装组缩短了住院时间（9.8 ± 3.3 天 vs. 10.6 ± 3.5 天，p = 0.009）。多变量分析表明，阿托伐他汀再装可使 30 天 MACE 风险降低 65%（比值比 0.35，95% 置信区间 0.18-0.86；p = 0.005）。结论：该试验表明，阿托伐他汀重新加载可以改善接受长期他汀类药物治疗且正在进行非心脏急诊手术的稳定型 CAD 患者的临床结果。
Objective: This study was designed to investigate whether patients with stable coronary artery disease (CAD) receiving chronic statin treatment who are undergoing noncardiac emergency surgery benefit from acute atorvastatin reload. Methods: A total of 500 patients with stable CAD and regular administration of statin before noncardiac emergency surgery were randomized to atorvastatin reload (n = 250) or placebo (n = 250). All patients received atorvastatin treatment thereafter. The primary end point was a 30-day incidence of major adverse cardiac events (MACE). Secondary end points were the incidence of atrial fibrillation (AF) during hospitalization and length of hospital stay. Results: The primary end point occurred in 2.4% of patients treated with atorvastatin reload and in 8% in the placebo arm (p = 0.0088). The incidence of AF during hospitalization was 6.8% in patients treated with atorvastatin reload and 17% in the placebo arm (p = 0.0003). Compared with the placebo arm, the atorvastatin reload arm shortened the length of stay (9.8 ± 3.3 vs. 10.6 ± 3.5 days, p = 0.009). Multivariable analysis suggested that atorvastatin reload conferred a 65% risk reduction of 30-day MACE (odds ratio 0.35, 95% confidence interval 0.18-0.86; p = 0.005). Conclusion: The trial suggests that atorvastatin reload may improve the clinical outcome of patients with stable CAD receiving chronic statin treatment who are undergoing noncardiac emergency surgery.
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影响因子：
158.5
作者：
Schouten, Olaf;Boersma, Eric;Poldermans, Don
通讯作者：
Poldermans, Don
影响因子：
2.3
作者：
Latifeh Nafasi;R. Rahmani;A. Shafiee;A. Salari;A. Abdollahi;A. Meysamie
通讯作者：
Latifeh Nafasi;R. Rahmani;A. Shafiee;A. Salari;A. Abdollahi;A. Meysamie
影响因子：
37.8
作者：
G. Shroff;Q. Orlandi
通讯作者：
G. Shroff;Q. Orlandi
影响因子：
37.8
作者：
Anderson, Jeffrey L.;Adams, Cynthia D.;Yancy, Clyde W.
通讯作者：
Yancy, Clyde W.
DOI：
10.1007/bf03009958
发表时间：
1990-01
期刊：
Canadian Journal of Anaesthesia
影响因子：
--
作者：
D. Mangano
通讯作者：
D. Mangano