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Cardiovascular clinical pharmaceutical research
The effects of high loading and high maintenance doses of atorvastatin on platelet activity and vascular endothelium function as well as prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention
  1. Zhangqiang Chen,
  2. Lang Hong,
  3. Hong Wang,
  4. Qiulin Yin,
  5. Li Xiang Lu,
  6. Hengli Lai,
  7. Linfeng Li
  1. Jiangxi Provincial People's Hospital, Jiangxi, China

Abstract

Objective To observe the effects of high loading doses and high maintenance dose of atorvastatin on platelet activity, function of vascular endothelium and inflammation as well as prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI).

Methods 100 patients with acute coronary syndrome were randomly divided into high loading doses of atorvastatin treatment group (atorvastatin group) (50 patients) and conventional treatment group (conventional group) (50 patients). 50 healthy people as control group. we examined the patient's blood CD62p, glucose protein (GP)αb/βa and endothelium 1(ET-1), Von Willebrand factor (vWF), nitric oxide (NO) levels and high sensitivity c reactive protein (hs-CRP) from before treatment and the second day after the treatment of PCI in both group. Then the patients in atorvastatin group received high loading doses (80 mg) and maintenance dose (40 mg, QN) of atorvastatin treatment for 4 weeks, and compared the results with conventional treatment group.

Results The ACS patient' s blood CD62p, GPαb/βa, vWF, ET-1 and hs-CRP levels increased significantly (all p<0.01), NO decreased significantly (p<0.01), compared with healthy control group. The ACS patient' s plasma levels of vWF increased significantly (p<0.05), CD62p, GPαb/βa decreased significantly (p<0.05) after PCI group compared with before PCI group. In both atorvastatin treatment group and convention treatment group, the patient's plasma levels of CD62p, GPαb/βa, vWF, ET-1 and hs-CRP decreased significantly (p<0.05, p<0.01) compared with pretreatment group, meanwhile there were different significantly of all parameters above between atorvastatin group and conventional treatment group (p<0.01, p<0.05). In addition, the parameter above showed significantly different after treatment of 4 weeks than 7 days (p<0.01, p<0.05). There were two cases of sudden death, seven cases of recurrent angina, three cases of ventricular tachycardiac (VT)/ventricular fibrillation (VF) in conventional treatment group after 4 weeks, while there were one case of recurrent angina, one case of heart failure, without VT/VF and sudden death occurred in the atorvastatin group after 4 weeks.

Conclusion High loading doses of atorvastatin can inhibit the patient's platelet activity and vascular inflammation and protect the vascular endothelium function as well as improve the prognosis after the treatment of PCI.

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