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首页> 外文期刊>Lipids in Health Disease >Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials
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Efficacy of high-dose rosuvastatin preloading in patients undergoing percutaneous coronary intervention: a meta-analysis of fourteen randomized controlled trials

机译:大剂量瑞舒伐他汀预负荷对经皮冠状动脉介入治疗患者的疗效:十四项随机对照试验的荟萃分析

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Background Numerous studies have evidenced that statins can reduce the incidence of cardiovascular disease. However, the effects of high-dose rosuvastatin (RSV) preloading in patients undergoing percutaneous coronary intervention (PCI) are controversial. Objective We attempted to identify and quantify the potential cardioprotective benefits of high-dose RSV preloading on final thrombolysis in myocardial infarction (TIMI) flow grade, major adverse cardiac events (MACE), and peri-procedural myocardial injury (PMI) in patients undergoing PCI. Methods Pubmed, EMBASE, Cochrane Central Register of Controlled Trials and ISI Web of Science databases were systematically searched for randomized controlled trials (RCTs) up to June 2015. We assessed the incidence of MACE and PMI in all enrolled patients for subgroups stratified by clinical presentation and previous statin therapy during the follow-up period. Results Fourteen trials with 3368 individuals were included in our meta-analysis. High-dose RSV preloading before PCI lead to a 58 % reduction in MACE (odds ratio [OR]?=?0.42, 95 % confidence intervals [CI]: 0.29-0.61, P?
机译:背景技术大量研究表明,他汀类药物可以减少心血管疾病的发生。然而,大剂量瑞舒伐他汀(RSV)预负荷对接受经皮冠状动脉介入治疗(PCI)的患者的作用尚有争议。目的我们试图确定并定量大剂量RSV预负荷对PCI患者的最终血栓溶解在心肌梗死(TIMI)血流分级,主要不良心脏事件(MACE)和围手术期心肌损伤(PMI)中的潜在心脏保护作用。方法截至2015年6月,系统地搜索Pubmed,EMBASE,Cochrane对照试验中心注册库和ISI Web of Science数据库以进行随机对照试验(RCT)。我们按临床表现分层对所有入组患者的MACE和PMI发生率进行了评估。以及后续随访期间的他汀类药物治疗。结果我们的荟萃分析包括14项3368人的试验。 PCI之前的大剂量RSV预加载导致MACE降低58%(奇数比[OR]?=?0.42,95%置信区间[CI]:0.29-0.61,P?<?0.00001),而MACE降低60%。 PMI(OR?=?0.40,95%CI:0.25–0.63,P?<?0.0001)。该程序还改善了接受PCI的患者的最终TIMI血流等级(OR≥1.61,95%CI:1.09–2.38,P≥0.02)。 MACE对稳定型心绞痛患者(OR≥0.42,95%CI:0.21-0.87,P≥0.02)和急性冠脉综合征(ACS)患者(OR≥0.42,95%CI)均具有显着意义:0.27-0.65,P≤<0.0001);以及他汀类初治患者(OR≥0.42,95%CI:0.28-0.64,P 0.0001)和既往他汀类药物治疗的患者(OR≥0.28,95%CI:0.10-0.73,P ?=?0.01)。结论大剂量RSV预负荷可显着改善PCI患者的心肌灌注,并降低MACE和PMI。预载RSV的心脏保护作用不仅对稳定型心绞痛和ACS患者而且对他汀初治和以前的他汀类药物治疗患者均具有重要意义。随访期预装RSV对心脏的保护作用主要是由于自发性MI和TVR降低,尤其是对于ACS和他汀类初治患者。

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