关键词: 急性心肌梗死, 他汀, 炎症, 经皮冠状动脉介入手术, 声学定量

Abstract:

Objective To explore the effects of atorvastatin administered to AMI patients before acute PCI on levels of inflammatory markers in systemic circulation or within ICA and left ventricular function 7 days after AMI. Methods  60 patients with STEMI who had undergone acute PCI were enrolled in this study. All patients were randomly assigned into the atorvastatin group (group A) and the control group (group B). Group A consisted of 32 patients who took 40mg atorvastatin while group B consisted of 28 patients who took a placebo. Blood samples were obtained from the peripheral vein and ICA at the beginning of PCI and from the   peripheral vein after 24 hours. IL-6, MMP-9, sCD40L were determined. The hemodynamic indexes of ventricular function by Acoustic Quantification (AQ) were measured as follows: EDV-LV, ESV-LV, LVEF, PER-LV, and PFR-LV. Results 1. Circulating level of IL-6 significantly decreased in group A compared with group B before PCI. Concentrations of IL-6, sCD40L and MMP-9 in system circulation 24 hours after PCI significantly decreased in group A compared with group B. The data of EDV-LV, ESV-LV, LVEF, PER-LV, and PFR-LV had no differences between group A and B.  2. Levels of MMP9, IL-6 and sCD40L were significantly higher in the ICA than in the systemic circulation in the two groups. Concentrations of IL-6 and MMP-9 increased after 24 hours in the two groups, but the level of sCD40L of the peripheral vein after 24 hours only increased in the controls. Conclusion  Levels of MMP-9, IL-6 and sCD40L are significantly higher in ICA than in the peripheral vein before acute PCI in STEMI patients. Atorvastatin administered to AMI patients just before PCI could cause decreased levels of inflammatory markers, but early administration of atorvastatin is not beneficial to left ventricular function in the short term.

Key words: Acute myocardial infarction; Statins; Inflammation; Percutaneous coronary intervention; Acoustic quantification