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首页> 外文期刊>The American Journal of Cardiology >Comparison of usefulness of simvastatin 20 mg versus 80 mg in preventing contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
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Comparison of usefulness of simvastatin 20 mg versus 80 mg in preventing contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention.

机译：比较辛伐他汀20毫克和80毫克在接受经皮冠状动脉介入治疗的急性冠脉综合征患者中预防造影剂诱发的肾病的有效性。

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Contrast-induced nephropathy limits the outcomes of percutaneous coronary intervention (PCI). The present study compared the protective effects of different statin doses on renal function. A total of 228 patients with acute coronary syndrome undergoing selective PCI were randomly divided into simvastatin 20-mg group (S20, n = 115) and simvastatin 80-mg group (S80, n = 113). Serum creatinine was measured at admission, the day of PCI, and 24 and 48 hours after PCI. The creatinine clearance was calculated using the Cochcroft-Gault formula. High-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 were also measured before and after the procedure. Contrast-induced nephropathy was defined as a postprocedure increase in serum creatinine of > or =0.5 mg/dl or >25% from baseline. The serum creatinine significantly increased after PCI, with the peak value occurring at 24 hours, and then began to decrease. At 48 hours, the serum creatinine had decreased to the baseline level in the S80 group, but it had failed to do so in the S20 group. At 24 and 48 hours after PCI, the serum creatinine was lower in the S80 group than in the S20 group (p <0.05 and p <0.001, respectively). The creatinine clearance significantly decreased after PCI, with the lowest value occurring at 24 hours, and then it began to increase. In the S80 group, the creatinine clearance recovered to baseline level at 48 hours, but it failed to do so in the S20 group. The creatinine clearance was greater at 24 and 48 hours in the S80 group than that in the S20 group. Although the procedure caused a significant increase in high-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 levels, the value was lower in the S80 group than in the S20 group (p <0.001). In conclusion, pretreatment with simvastatin 80 mg before PCI could further decrease the occurrence of contrast-induced nephropathy compared with simvastatin 20 mg. This benefit was associated with the lowering of high-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 levels.
机译：造影剂诱发的肾病限制了经皮冠状动脉介入治疗（PCI）的结果。本研究比较了不同他汀类药物剂量对肾脏功能的保护作用。 228例接受选择性PCI的急性冠脉综合征患者被随机分为辛伐他汀20 mg组（S20，n = 115）和辛伐他汀80 mg组（S80，n = 113）。在入院时，PCI当天以及PCI后24小时和48小时测量血清肌酐。使用Cochcroft-Gault公式计算肌酐清除率。在手术前后还测量了高敏C反应蛋白，P-选择素和细胞间粘附分子-1。造影剂诱发的肾病定义为术后肌酐比基线增加>或= 0.5 mg / dl或> 25％。 PCI后，血清肌酐明显升高，峰值出现在24小时，然后开始下降。在第48小时，S80组的血清肌酐已降至基线水平，但S20组却未达到基线水平。 PCI后24和48小时，S80组的血清肌酐低于S20组（分别为p <0.05和p <0.001）。 PCI后肌酐清除率显着下降，最低值出现在24小时，然后开始增加。在S80组中，肌酐清除率在48小时时恢复到基线水平，但在S20组中未能恢复到基线水平。 S80组在24和48小时的肌酐​​清除率高于S20组。尽管该程序导致高敏C反应蛋白，P-选择蛋白和细胞间粘附分子1的水平显着增加，但S80组的值低于S20组（p <0.001）。总之，与辛伐他汀20 mg相比，PCI前用辛伐他汀80 mg进行预处理可以进一步减少造影剂诱发的肾病的发生。这种益处与降低高敏C反应蛋白，P选择素和细胞间粘附分子1水平有关。

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