摘要
This study evaluated whether pretreatment with statins was associated with a d ecreased incidence of periprocedural myocardial injury. Periprocedural myocardia l injury occurs after percutaneous coronary intervention(PCI) and is associated with adverse outcomes. The pleiotropic properties of statins stabilize plaque an d decrease the inflammatory milieu of atherosclerotic lesions. Accordingly, we h ypothesized that preprocedural statin therapy would decrease periprocedural myoc ardial injury. We enrolled 425 patients who underwent successful PCI. The contro l arm (n=150) included patients not on statin therapy at the time of PCI, and th e statin arm(n=275) included patients who were taking statin medication before P CI. All patients had serial enzymes measured, including creatine kinase (CK), CK -MB, and troponin I. The incidence of increased levels of CK and CK-MB >3 time s normal and the absolute increase in CK and troponin I were compared between gr oups. The control arm had significantly higher periprocedural levels of CK. In t he control group, 6%of patients had CK increases >3 times the upper limit of no rmal compared with 1.8%in the statin group(p=0.02). The control arm had a highe r frequency of CK-MB increases >3 times the upper limit of normal(7.3%vs 2.2% , p =0.01). There was a trend toward higher levels of troponin I in the control group(3.21 vs 1.85 ng/ml, p=0.06). Thus, statin therapy before elective PCI was associated with lower levels of periprocedural CK.
This study evaluated whether pretreatment with statins was associated with a d ecreased incidence of periprocedural myocardial injury. Periprocedural myocardia l injury occurs after percutaneous coronary intervention(PCI) and is associated with adverse outcomes. The pleiotropic properties of statins stabilize plaque an d decrease the inflammatory milieu of atherosclerotic lesions. Accordingly, we h ypothesized that preprocedural statin therapy would decrease periprocedural myoc ardial injury. We enrolled 425 patients who underwent successful PCI. The contro l arm (n=150) included patients not on statin therapy at the time of PCI, and th e statin arm(n=275) included patients who were taking statin medication before P CI. All patients had serial enzymes measured, including creatine kinase (CK), CK -MB, and troponin I. The incidence of increased levels of CK and CK-MB >3 time s normal and the absolute increase in CK and troponin I were compared between gr oups. The control arm had significantly higher periprocedural levels of CK. In t he control group, 6%of patients had CK increases >3 times the upper limit of no rmal compared with 1.8%in the statin group(p=0.02). The control arm had a highe r frequency of CK-MB increases >3 times the upper limit of normal(7.3%vs 2.2% , p =0.01). There was a trend toward higher levels of troponin I in the control group(3.21 vs 1.85 ng/ml, p=0.06). Thus, statin therapy before elective PCI was associated with lower levels of periprocedural CK.
