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目的:探讨他汀预处理对经皮行冠状动脉介入治疗(PCI)患者随访期间的主要心脑血管事件(MACCE)发生的影响。方法:回顾性分析2003年6月至2005年9月北京安贞医院行PCI手术患者3893例,根据是否接受他汀预处理分为他汀预处理组(n=3361)和非他汀预处理组(n=532),比较两组一般的临床特征和人口学资料并进行随访,采用多因素COX回归分析他汀预处理对PCI患者的随访期间的MACCE的影响的独立危险因素。结果:他汀预处理不能降低随访期间病死率和总MACCE事件(1.7%vs.1.3%;12.9%vs.8.9%,P>0.05),在校正年龄、性别等临床基线数据后,COX回归分析显示:他汀预处理组与非他汀预处理组比较,PCI患者随访期间死亡风险RR值为1.168(95%CI0.33～4.136,P=0.810)。结论:他汀预处理不能够降低随访期间总心脑血管事件和住院期间病死率的风险,随访期间死亡事件的独立的预测因素为年龄、射血分数<50%、三支冠状动脉病变、女性、血肌苷水平。
Objective: To investigate the effect of statin preconditioning on major cardio-cerebrovascular events (MACCE) during percutaneous coronary intervention (PCI). Methods: 3893 patients undergoing PCI in Beijing Anzhen Hospital from June 2003 to September 2005 were retrospectively analyzed. According to the statin pretreatment, they were divided into statin pretreatment group (n = 3361) and non - statin pretreatment group (n = 532). The clinical characteristics and demographic data of two groups were compared and followed up. Multivariate Cox regression was used to analyze the independent risk factors of the effect of statin preconditioning on MACCE during follow-up of PCI. RESULTS: Statin preconditioning did not reduce mortality and overall MACCE events during follow-up (1.7% vs. 1.3%; 12.9% vs.8.9%, P> 0.05). After adjusting for clinical baseline data such as age and gender, COX regression analysis : Compared with non-statin pretreatment group, RR of death in PCI patients was 1.168 (95% CI 0.33 ~ 4.136, P = 0.810). CONCLUSIONS: Statin preconditioning did not reduce the risk of total cardiovascular events and hospital-acquired mortality during follow-up. Independent predictors of mortality during follow-up were age, ejection fraction <50%, three coronary lesions, females, Serum inosine levels.