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【文摘发布】ARMYDA-ACS 试验结果：阿托伐他汀预处
Results of the ARMYDA-ACS Randomized Trial
Giuseppe Patti, MD, FACC*, Vincenzo Pasceri, MD, PhD, FACC, Giuseppe Colonna, MD, Marco Miglionico, MD*, Dionigi Fischetti, MD, Gennaro Sardella, MD, FACC, Antonio Montinaro, MD and Germano Di Sciascio, MD, FACC, FESC*,*
Objectives: This study sought to investigate potential protective effects of atorvastatin in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI).
Background: Randomized studies have shown that pretreatment with atorvastatin may reduce periprocedural myocardial infarction in patients with stable angina during elective PCI; however, this therapy has not been tested in patients with ACS.
Methods: A total of 171 patients with non–ST-segment elevation ACS were randomized to pretreatment with atorvastatin (80 mg 12 h before PCI, with a further 40-mg preprocedure dose [n = 86]) or placebo (n = 85). All patients were given a clopidogrel 600-mg loading dose. All patients received long-term atorvastatin treatment thereafter (40 mg/day). The main end point of the trial was a 30-day incidence of major adverse cardiac events (death, myocardial infarction, or unplanned revascularization).
Results: The primary end point occurred in 5% of patients in the atorvastatin arm and in 17% of those in the placebo arm (p = 0.01); this difference was mostly driven by reduction of myocardial infarction incidence (5% vs. 15%; p = 0.04). Postprocedural elevation of creatine kinase-MB and troponin-I was also significantly lower in the atorvastatin group (7% vs. 27%, p = 0.001 and 41% vs. 58%, p = 0.039, respectively). At multivariable analysis, pretreatment with atorvastatin conferred an 88% risk reduction of 30-day major adverse cardiac events (odds ratio 0.12, 95% confidence interval 0.05 to 0.50; p = 0.004).
Conclusions: The ARMYDA-ACS trial indicates that even short-term pretreatment with atorvastatin may improve outcomes in patients with ACS undergoing early invasive strategy. These findings may support routine use of high-dose statins before intervention in patients with ACS.
来源：J Am Coll Cardiol, 2007; 49:1272-1278 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 标题： ARMYDA-ACS 试验结果：阿托伐他汀预处理能改善急性冠脉综合征患者早期行介入治疗的预后
Giuseppe Patti, MD, FACC*, Vincenzo Pasceri, MD, PhD, FACC, Giuseppe Colonna, MD, Marco Miglionico, MD*, Dionigi Fischetti, MD, Gennaro Sardella, MD, FACC, Antonio Montinaro, MD and Germano Di Sciascio, MD, FACC, FESC*,*
来源：JACC
Objectives: This study sought to investigate potential protective effects of atorvastatin in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI).
目的：本研究旨在探索阿托伐他汀对急性冠脉综合征（ACS）患者行经皮冠脉介入治疗（PCI）潜在的保护作用。
Background: Randomized studies have shown that pretreatment with atorvastatin may reduce periprocedural myocardial infarction in patients with stable angina during elective PCI; however, this therapy has not been tested in patients with ACS.
背景：随机试验表明，阿托伐他汀能减少稳定型心绞痛患者行择期PCI围手术期心肌梗死发生率，然而，目前尚不清楚ACS患者是否也能从中获益。
Methods: A total of 171 patients with non–ST-segment elevation ACS were randomized to pretreatment with atorvastatin (80 mg 12 h before PCI, with a further 40-mg preprocedure dose [n = 86]) or placebo (n = 85). All patients were given a clopidogrel 600-mg loading dose. All patients received long-term atorvastatin treatment thereafter (40 mg/day). The main end point of the trial was a 30-day incidence of major adverse cardiac events (death, myocardial infarction, or unplanned revascularization).
方法：共171名无ST段抬高型ACS患者随机分为阿托伐他汀预处理组（PCI前12小时服用80mg，术前服用40mg，共86名）和安慰剂组（85名）.所有的患者在术前都服用600mg负荷剂量的氯吡格雷，术后长期服用阿托伐他汀（40mg/d）。试验的主要临床终点为30天主要不良心脏事件发生率（死亡，心肌梗死，计划外血运重建）。
Results: The primary end point occurred in 5% of patients in the atorvastatin arm and in 17% of those in the placebo arm (p = 0.01); this difference was mostly driven by reduction of myocardial infarction incidence (5% vs. 15%; p = 0.04). Postprocedural elevation of creatine kinase-MB and troponin-I was also significantly lower in the atorvastatin group (7% vs. 27%, p = 0.001 and 41% vs. 58%, p = 0.039, respectively). At multivariable analysis, pretreatment with atorvastatin conferred an 88% risk reduction of 30-day major adverse cardiac events (odds ratio 0.12, 95% confidence interval 0.05 to 0.50; p = 0.004).
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作者:admin@医学,生命科学 2011-09-02 05:12
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