氟伐他汀对首次成功的PCI术后心血管事件的预防作用

Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention

目的探讨氟伐他汀对冠心病首次成功的经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)的影响。方法86例首次成功PCI术后患者,总胆固醇水平在3.5￣7.0mmol/L(135￣270mg/dL)之间。空腹甘油三脂水平小于4.5mmol/L(400mg/dL)。随机分为治疗组(常规治疗外,加服氟伐他汀,44例)和对照组(仅常规治疗,42例),治疗组氟伐他汀40mg/d。比较治疗组和对照组间无主要不良心血管事件(MACE)的生存时间。结果治疗组无主要不良心血管事件(MACE)的生存时间显著延长(P=0.01),治疗组有9例(20.5%),对照组有11例(26.2%)患者至少发生了一次主要不良心血管事件(MACE)P=0.01。结论对总胆固醇水平正常或轻度升高,首次成功的经皮冠状动脉介入治疗(PCI)的冠心病患者,氟伐他汀可显著减少主要不良心血管事件发生(MACE)的危险性。

[Objective] To determine whether treatment with fluvastatin reduces MACE in patients who have undergone PCI, [Methods] 86 patients with stable or unstable angina or silent iscbemia following successful completion of their first PCI who had baseline total cholesterol levels between 135 and 270 mg/dL （3.5-7.0 mmol/L）, with fasting triglyceride levels of less than 400 mg/dL （4.5 mmol/L） were randomly assigned to receive treatment with flu- vastatin, treatment group 40 mg/d, or control group at hospital discharge for 3 to 4 years. [Results] MACE-free survival time was significantly longer in the fluvastatin group than in the control group （P =0.01）. Nine （20.5%） of 44 patients in the fluvastatin group and Eleven （26.2%） of 42 patients in the placebo group had at least 1 MACE. [Conclusion] Fluvastatin treatment in patients with average cholesterol levels undergoing their first successful PCI significantly reduces the risk of major adverse cardiac events.