Randomized Trial of Statin Administration for Myocardial Injury : Is Intensive Lipid-Lowering More Beneficial Than Moderate Lipid-Lowering Before Percutaneous Coronary Intervention?

元データ 2007-07-20 社団法人日本循環器学会

概要

Background Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy. Methods and Results Subjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C) <70mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C <100mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial damage was 14.2% in Group A and 47.6% in Group B (p=0.043). CK-MB was above the upper limit of normal (ULN) in 19% of Group A and 33.3% of Group B (p=0.44), and CK-MB was >3×ULN in 9.5% of Group A and 19% of Group B (p=0.66). Conclusions Intensive lipid-lowering therapy before PCI reduces minor myocardial damage during PCI with stenting compared with moderate lipid-lowering therapy.

著者

Ogawa Satoshi Division of Cardiology, Department of Medicine, Keio University School of Medicine
Fukuda Keiichi Keio University School Of Medicine
Fukuda Keiichi Department Of Medicine Keio University
Fukuda Keiichi Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine
Kinoshita Masaka Division Of Cardiology Department Of Internal Medicine Keio University School Of Medicine:division O
Miyoshi Shunichiro Cardiology Division Keio University School Of Medicine
Miyoshi Shunichiro Cardiopulmonary Division Department Of Medicine Keio University
Kinoshita Masayoshi Division Of Cardiology Department Of Internal Medicine Keio University School Of Medicine:division O
Matsumura Shin-ichirou Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine
Sueyoshi Kouichirou Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine
Sueyoshi Kouichirou Division Of Cardiology Department Of Internal Medicine Keio University School Of Medicine:division O
Miyoshi Shunitirou Department Of Cardiovascular Medicine Keio Univercity
Miyoshi Shunichiro Cardiopulmonary Division Keio University School Of Medicine
Fukuda Keiichi Department Of Regenerative Medicine School Of Medicine Keio University
Matsumura Shin-ichiro Departments Of Internal Medicine School Of Medicine Keio University
Miyoshi Shunichiro Cardiology Division Department Of Medicine Keio University School Of Medicine
Fukuda Keiichi Department Of Regenerative Medicine And Advanced Cardiac Therapeutics Keio University School Of Medi
Fukuda Keiichi Division Of Cardiology Department Of Medicine Keio University School Of Medicine
Miyoshi Shunitirou Cardiology Keio University School Of Medicine

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