Influence of different dose of atorvastatin on ventricular remodeling and platelet activation in patients with acute myocardial infarction / 中国基层医药

ABSTRACT

Objective To investigate the influence of different dose of atorvastatin on ventricular remodeling and platelet activation in patients with acute myocardial infarction(AMI).Methods From December 2014 to October 2016,170 patients with acute ST segment elevation myocardial infarction in the Central Hospital of Shan County were chosen and randomly divided into control group(low dose atorvastatin)and research group(high dose atirvastatin). The platelet index before operation and 48h after operation,echocardiographic index 7d after operation and 6 months after operation,adverse reaction and major adverse cardiac events (MACE)were compared between the two groups. Results Before operation,the platelet index between the two groups had no statistically significant differences(t＝0.549,0.376,0.250,0.098,all P＞0.05).At 48 h after operation,the mean platelet volume (MPV),platelet－large ratio (P－LCR),peripheral blood platelet (CD62p),activation of Gp IIb/IIIa complex (PAC－1)of the research group were (12.93 ±1.74)fL,(29.05 ±5.79)%,(45.29 ±5.23)%,(74.53 ±5.52)%,which were lower than those of the control group[(14.21±1.82)fL,(30.94 ±6.15)%,(48.37 ±4.82)%,(78.49 ±5.76)%],the differences were statistically significant (t＝4.687,2.063,3.993,4.576,all P＜0.05).In the research group,62 cases (72.94%)were TMPG good,49 cases(57.64%)in the control group,the difference between two groups was statisti- cally significant (χ2＝4.387,P＞0.05).Echocardiographic indicators 7d after operation between the two groups had no statistically significant differences(t＝0.160,0.467,0.448,0.745,all P＞0.05).Six months after operation,the left ventricular ejection fraction (LVEF)of the research group[(50.11±3.79)%]was higher than that of the control group[(48.45 ±4.10)%],the left ventricular end diastolic volume (LVEDV)[(110.13 ±8.83)mL],left ventricular end systolic diameter (LVESV)[(60.18 ±6.07)mL],left ventricular mass index (LVMI)[(101.52 ± 4.33)g/m2]of the research group were lower than those of the control group [(112.84 ±8.46 )mL,(63.51± 5.51)mL,(103.94 ±4.19)g/m2],the differences were statistically significant (t＝2.043,3.745,3.703,2.741,all P＜0.05).The incidence rate of liver damage and myopathy between the two groups had no statistically significant difference(χ2＝0.525,0.000,all P＞0.05).There were 6 cases of MACE occurred in the research group,16 cases occurred in the control group,Kaplan－Meier survival analysis showed cumulative non MACE event survival rate of the research group(92.94%)was higher than that of the control group(81.17%),the difference was statistically significant (Logrank＝0.411,P＜0.05 ).Conclusion High atorvastatin dose can better improve the platelet and ventricular remodeling,and with good safety and prognosis.