炎症とスタチンの効果の関係 経皮冠動脈介入後のスタチンの効果
Albert W Chan1, Deepak L Bhatt, Derek P Chew
1Catheterization Laboratory, Department of Cardiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, La 70121, USA. achan@ochsner.org
Circulation
|April 1, 2003
まとめ
経皮冠動脈干渉 (PCI) 前のスタチンの治療は,炎症マーカーが高い患者の死亡率を著しく減少させます. 高感度C反応性タンパク質 (hsCRP) ガイドされた戦略は,スタチンの使用を最適化し,PCI後の結果を改善することができます.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- バイオケミストリー バイオケミストリー
背景:
- スタチンは,脂質を下げること以外にも,抗炎症および抗血栓性を持つ.
- 新興の証拠によると,スタチンは,経皮冠動脈介入 (PCI) の後の早期の有害事象を減らす可能性があることを示唆しています.
- 炎症,スタチンの使用,およびPCIのアウトカムとの相互作用については,さらなる調査が必要です.
研究 の 目的:
- 処置前の炎症,スタチンの使用,PCI後の臨床結果との関係を調査する.
- スタチン療法がPCI患者における高感度C反応性タンパク質 (hsCRP) の予後値を変更するかどうかを判断する.
主な方法:
- PCIを受けた1552人の患者の将来的なフォローアップ,例行的な処置前のhsCRP測定.
- スタチンの使用,hsCRPレベル,心筋梗塞 (MI),および1年間の死亡率の分析.
- 多変量分析と傾向スコア調整により,結果の独立した予測要因を評価します.
主要な成果:
- スタチンを前治療した患者は,hsCRP濃度が低下し,手術周りの心筋梗塞率が低下した.
- スタチンの前治療は,1年生存率の改善と関連しており,特に最も高いhsCRP濃度を有する患者では特にそうでした.
- 処置前のhsCRPは,スタチンを服用していない人に対してのみ,1年間の死亡またはMIを独立して予測した;スタチンの前治療は,最も高いhsCRP四分位数における生存の独立した予測要因であった.
結論:
- PCI前のスタチン治療は,hsCRPレベルが上昇した患者の死亡率を著しく減少させます.
- hsCRPレベルによる戦略は,PCIを受けている患者のスタチン治療の有効性を高める可能性があります.
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