The effects of prior use of atorvastatin on coronary blood flow after primary percutaneous coronary intervention in patients presenting with acute myocardial infarction
The effects of prior use of atorvastatin on coronary blood flow after primary percutaneous coronary intervention in patients presenting with acute myocardial infarction
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DOI：
10.1097/00019501-200508000-00010
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发表时间：
2005-08-01
影响因子：
1.8
通讯作者：
Isik, E
中科院分区：
文献类型：
--
作者：
Celik, T;Kursaklioglu, H;Isik, E
背景他汀类药物对血管系统有多种有利的作用，这些作用与其称为多效性的降脂功能没有直接关系。关于急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）后既往使用他汀类药物对冠状动脉血流量的影响，尚无足够的数据。因此，在本研究中，我们的目的是调查使用溶栓心肌梗死（TIMI）帧计数法的AMI患者的主PCI后，冠状动脉血流量的影响，先前他汀类药物的使用包括200例患者（161名男性，平均年龄= 62 +/- 7岁）提到的心脏病诊所与AMI谁随后进行了成功的主PCI。研究人群根据直接PCI前他汀类药物的使用情况分为两组。第1组包括98例未服用他汀类药物的患者（75例男性;平均年龄= 63 ± 7岁），第2组包括102例每日服用至少40 mg阿托伐他汀至少6个月的患者（86例男性;平均年龄= 61 ± 7岁）。结果服用阿托伐他汀40 mg以上6个月以上的患者，仅平均TIMI帧数显著低于未服用阿托伐他汀的患者（P < 0.001）;在控制混杂变量后，第2组患者的平均TIMI帧数显著低于第1组患者（P=0.001）。疼痛的球囊时间和血管类型被检测为重要的混杂变量的TIMI帧计数后协方差analysis.Conclusions先前他汀类药物的使用可能会改善冠状动脉血流量PCI后的AMI患者，可能通过其有益的影响微血管功能。
Background Statins exert a variety of favourable effects on the vascular system not directly related to their lipid lowering function known as pleiotropic effects. There are not enough data regarding the effects of prior statin use on coronary blood flow after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Accordingly, in the present study, we aimed to investigate the effects of prior statin use on coronary blood flow after primary PCI in patients with AMI using the Thrombolysis In Myocardial Infarction (TIMI) frame count method.Methods The study population consisted of 200 patients (161 men; mean age = 62 +/- 7 years) referred to cardiology clinics with AMI who subsequently underwent successful primary PCI. The study population was divided into two groups according to statin use before primary PCI. Group 1 consisted of 98 patients (75 men; mean age = 63 +/- 7 years) not taking statin and group 2 consisted of 102 patients (86 men; mean age = 61 +/- 7 years) taking daily dose of at least 40 mg atorvastatin for at least 6 months. Coronary blood flow was determined by TIMI frame count method using the angiographic images obtained just after PCI and stenting.Results Only mean TIMI frame count was detected to be significantly lower in patients taking at least 40 mg atorvastatin for at least 6 months compared with that of the patients taking no statin (P < 0.001). After confounding variables were controlled for, the mean TIMI frame count of patients in group 2 was significantly lower than that of the patients in group 1 (P=0.001). Pain to balloon time and vessel type were detected as important confounding variables of TIMI frame count after analysis of covariances.Conclusions Prior statin use may improve coronary blood flow after PCI in patients with AMI, possibly by its beneficial effects on microvascular function.