Efficacy and Safety of Loading-Dose Rosuvastatin Therapy in Elderly Patients with Acute Coronary Syndromes Undergoing Elective Percutaneous Coronary Intervention

Objectives The aim of this work was to investigate the efficacy and safety of loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing elective percutaneous coronary intervention (PCI). Methods A total of 126 patients (≥70 year...

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Veröffentlicht in:Clinical drug investigation 2015-12, Vol.35 (12), p.777-784
Hauptverfasser: Jiao, Yungen, Hu, Feng, Zhang, Zhengang, Gong, Kaizheng, Sun, Xiaoning, Li, Aihua, Liu, Naifeng
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container_end_page 784
container_issue 12
container_start_page 777
container_title Clinical drug investigation
container_volume 35
creator Jiao, Yungen
Hu, Feng
Zhang, Zhengang
Gong, Kaizheng
Sun, Xiaoning
Li, Aihua
Liu, Naifeng
description Objectives The aim of this work was to investigate the efficacy and safety of loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing elective percutaneous coronary intervention (PCI). Methods A total of 126 patients (≥70 years old) with NSTEACS were randomly divided into two groups: (1) loading-dose rosuvastatin-treated group, treated with rosuvastatin 20 mg 12 h prior to PCI, with a second dose administered just before PCI ( n  = 62), and (2) control-treated group, treated with the standard method according to ACC/AHA guidelines in UAP/NSTEMI 2007 ( n  = 64). All patients were required to take rosuvastatin 10 mg once a day starting 24 h after the surgery irrespective of the initial randomization assignment. The serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLox-1), high-sensitivity C-reactive protein (hs-CRP), creatinine kinase (CK)-MB, cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) levels were measured prior to PCI and at 24 h and 30 days after PCI in both groups. The left ventricular ejection fraction (LVEF) levels were recorded prior to PCI and 30 days after PCI in both groups. Results Compared to pre-PCI, the serum sLox-1, hs-CRP, CK-MB, and cTnI levels were increased at 24 h after PCI (all p  
doi_str_mv 10.1007/s40261-015-0335-1
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Methods A total of 126 patients (≥70 years old) with NSTEACS were randomly divided into two groups: (1) loading-dose rosuvastatin-treated group, treated with rosuvastatin 20 mg 12 h prior to PCI, with a second dose administered just before PCI ( n  = 62), and (2) control-treated group, treated with the standard method according to ACC/AHA guidelines in UAP/NSTEMI 2007 ( n  = 64). All patients were required to take rosuvastatin 10 mg once a day starting 24 h after the surgery irrespective of the initial randomization assignment. The serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLox-1), high-sensitivity C-reactive protein (hs-CRP), creatinine kinase (CK)-MB, cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) levels were measured prior to PCI and at 24 h and 30 days after PCI in both groups. The left ventricular ejection fraction (LVEF) levels were recorded prior to PCI and 30 days after PCI in both groups. Results Compared to pre-PCI, the serum sLox-1, hs-CRP, CK-MB, and cTnI levels were increased at 24 h after PCI (all p  &lt; 0.05) in both groups. However, the increased sLox-1, hs-CRP, CK-MB, and cTnI values were significantly lower in the loading-dose rosuvastatin-treated group than in the control-treated group ( p  &lt; 0.05). In addition the serum sLox-1 and hs-CRP levels were lower in the loading-dose rosuvastatin-treated group than in the control-treated group at 30 days after PCI. However, the decreased values of sLox-1and hs-CRP from 24 h after PCI to 30 days after PCI did not show any significant difference between the two groups. No significant difference was found in the serum ALT and Scr levels between the two groups before and after PCI. Compared to the control-treated group, the serum BNP level decreased ( p  &lt; 0.05) and LVEF ( p  &lt; 0.05) increased in the loading-dose rosuvastatin-treated group at 30 days after PCI. Conclusion The loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes undergoing elective PCI can attenuate the increase in serum hs-CRP, sLox-1, CK-MB, and cTnI levels, reduce myocardial injury and inflammatory reaction caused by PCI, and improve the LVEF level at 30 days after PCI, ensuring an effective and safe therapy.</description><identifier>ISSN: 1173-2563</identifier><identifier>EISSN: 1179-1918</identifier><identifier>DOI: 10.1007/s40261-015-0335-1</identifier><identifier>PMID: 26387028</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acute Coronary Syndrome - diagnosis ; Acute Coronary Syndrome - drug therapy ; Acute Coronary Syndrome - surgery ; Aged ; Aged, 80 and over ; Elective Surgical Procedures - methods ; Female ; Gastrointestinal Diseases - chemically induced ; Gastrointestinal Diseases - diagnosis ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration &amp; dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Internal Medicine ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Original Research Article ; Percutaneous Coronary Intervention - methods ; Pharmacology/Toxicology ; Pharmacotherapy ; Rosuvastatin Calcium - administration &amp; dosage ; Treatment Outcome</subject><ispartof>Clinical drug investigation, 2015-12, Vol.35 (12), p.777-784</ispartof><rights>Springer International Publishing Switzerland 2015</rights><rights>Copyright Springer Science &amp; Business Media Dec 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-6237af866b9c34589caf7f4f2eb85277f0f9b82c8bb28ff589226b94655b731e3</citedby><cites>FETCH-LOGICAL-c442t-6237af866b9c34589caf7f4f2eb85277f0f9b82c8bb28ff589226b94655b731e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40261-015-0335-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40261-015-0335-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26387028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiao, Yungen</creatorcontrib><creatorcontrib>Hu, Feng</creatorcontrib><creatorcontrib>Zhang, Zhengang</creatorcontrib><creatorcontrib>Gong, Kaizheng</creatorcontrib><creatorcontrib>Sun, Xiaoning</creatorcontrib><creatorcontrib>Li, Aihua</creatorcontrib><creatorcontrib>Liu, Naifeng</creatorcontrib><title>Efficacy and Safety of Loading-Dose Rosuvastatin Therapy in Elderly Patients with Acute Coronary Syndromes Undergoing Elective Percutaneous Coronary Intervention</title><title>Clinical drug investigation</title><addtitle>Clin Drug Investig</addtitle><addtitle>Clin Drug Investig</addtitle><description>Objectives The aim of this work was to investigate the efficacy and safety of loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing elective percutaneous coronary intervention (PCI). Methods A total of 126 patients (≥70 years old) with NSTEACS were randomly divided into two groups: (1) loading-dose rosuvastatin-treated group, treated with rosuvastatin 20 mg 12 h prior to PCI, with a second dose administered just before PCI ( n  = 62), and (2) control-treated group, treated with the standard method according to ACC/AHA guidelines in UAP/NSTEMI 2007 ( n  = 64). All patients were required to take rosuvastatin 10 mg once a day starting 24 h after the surgery irrespective of the initial randomization assignment. The serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLox-1), high-sensitivity C-reactive protein (hs-CRP), creatinine kinase (CK)-MB, cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) levels were measured prior to PCI and at 24 h and 30 days after PCI in both groups. The left ventricular ejection fraction (LVEF) levels were recorded prior to PCI and 30 days after PCI in both groups. Results Compared to pre-PCI, the serum sLox-1, hs-CRP, CK-MB, and cTnI levels were increased at 24 h after PCI (all p  &lt; 0.05) in both groups. However, the increased sLox-1, hs-CRP, CK-MB, and cTnI values were significantly lower in the loading-dose rosuvastatin-treated group than in the control-treated group ( p  &lt; 0.05). In addition the serum sLox-1 and hs-CRP levels were lower in the loading-dose rosuvastatin-treated group than in the control-treated group at 30 days after PCI. However, the decreased values of sLox-1and hs-CRP from 24 h after PCI to 30 days after PCI did not show any significant difference between the two groups. No significant difference was found in the serum ALT and Scr levels between the two groups before and after PCI. Compared to the control-treated group, the serum BNP level decreased ( p  &lt; 0.05) and LVEF ( p  &lt; 0.05) increased in the loading-dose rosuvastatin-treated group at 30 days after PCI. Conclusion The loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes undergoing elective PCI can attenuate the increase in serum hs-CRP, sLox-1, CK-MB, and cTnI levels, reduce myocardial injury and inflammatory reaction caused by PCI, and improve the LVEF level at 30 days after PCI, ensuring an effective and safe therapy.</description><subject>Acute Coronary Syndrome - diagnosis</subject><subject>Acute Coronary Syndrome - drug therapy</subject><subject>Acute Coronary Syndrome - surgery</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Elective Surgical Procedures - methods</subject><subject>Female</subject><subject>Gastrointestinal Diseases - chemically induced</subject><subject>Gastrointestinal Diseases - diagnosis</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration &amp; dosage</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Original Research Article</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacotherapy</subject><subject>Rosuvastatin Calcium - administration &amp; dosage</subject><subject>Treatment Outcome</subject><issn>1173-2563</issn><issn>1179-1918</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc9u1DAQxiMEoqXwAFyQJS69BGwn_pNjtSxQaaVWtD1HjjPepsrai-0syuP0TZmSAhUSpxlpft83Y39F8ZbRD4xS9THVlEtWUiZKWlWiZM-KY8ZUU7KG6ee_-qrkQlZHxauU7ihlkkn-sjjistKKcn1c3K-dG6yxMzG-J1fGQZ5JcGQTTD_4bfkpJCDfQpoOJmWTB0-ubyGa_UywXY89xHEmlzgAnxP5MeRbcmanDGQVYvAmzuRq9n0MO0jkxiO-DWiLSrB5OAC5hIi48RCm9Fdz7jPEA1oOwb8uXjgzJnjzWE-Km8_r69XXcnPx5Xx1tiltXfNcSl4p47SUXWOrWujGGqdc7Th0WnClHHVNp7nVXce1cwhwjmwthehUxaA6KU4X330M3ydIud0NycI4Lse1-JeqVkJohej7f9C7MEWP1yElVKO0VA1SbKFsDClFcO0-Djt8Xsto-5Bfu-TXYn7tQ34tQ827R-ep20H_R_E7MAT4AiQc-S3EJ6v_6_oT1NKoLw</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Jiao, Yungen</creator><creator>Hu, Feng</creator><creator>Zhang, Zhengang</creator><creator>Gong, Kaizheng</creator><creator>Sun, Xiaoning</creator><creator>Li, Aihua</creator><creator>Liu, Naifeng</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Efficacy and Safety of Loading-Dose Rosuvastatin Therapy in Elderly Patients with Acute Coronary Syndromes Undergoing Elective Percutaneous Coronary Intervention</title><author>Jiao, Yungen ; 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Public Health</topic><topic>Middle Aged</topic><topic>Original Research Article</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacotherapy</topic><topic>Rosuvastatin Calcium - administration &amp; dosage</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiao, Yungen</creatorcontrib><creatorcontrib>Hu, Feng</creatorcontrib><creatorcontrib>Zhang, Zhengang</creatorcontrib><creatorcontrib>Gong, Kaizheng</creatorcontrib><creatorcontrib>Sun, Xiaoning</creatorcontrib><creatorcontrib>Li, Aihua</creatorcontrib><creatorcontrib>Liu, Naifeng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Health &amp; 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Methods A total of 126 patients (≥70 years old) with NSTEACS were randomly divided into two groups: (1) loading-dose rosuvastatin-treated group, treated with rosuvastatin 20 mg 12 h prior to PCI, with a second dose administered just before PCI ( n  = 62), and (2) control-treated group, treated with the standard method according to ACC/AHA guidelines in UAP/NSTEMI 2007 ( n  = 64). All patients were required to take rosuvastatin 10 mg once a day starting 24 h after the surgery irrespective of the initial randomization assignment. The serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLox-1), high-sensitivity C-reactive protein (hs-CRP), creatinine kinase (CK)-MB, cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) levels were measured prior to PCI and at 24 h and 30 days after PCI in both groups. The left ventricular ejection fraction (LVEF) levels were recorded prior to PCI and 30 days after PCI in both groups. Results Compared to pre-PCI, the serum sLox-1, hs-CRP, CK-MB, and cTnI levels were increased at 24 h after PCI (all p  &lt; 0.05) in both groups. However, the increased sLox-1, hs-CRP, CK-MB, and cTnI values were significantly lower in the loading-dose rosuvastatin-treated group than in the control-treated group ( p  &lt; 0.05). In addition the serum sLox-1 and hs-CRP levels were lower in the loading-dose rosuvastatin-treated group than in the control-treated group at 30 days after PCI. However, the decreased values of sLox-1and hs-CRP from 24 h after PCI to 30 days after PCI did not show any significant difference between the two groups. No significant difference was found in the serum ALT and Scr levels between the two groups before and after PCI. Compared to the control-treated group, the serum BNP level decreased ( p  &lt; 0.05) and LVEF ( p  &lt; 0.05) increased in the loading-dose rosuvastatin-treated group at 30 days after PCI. Conclusion The loading-dose rosuvastatin therapy in elderly patients with non-ST-segment elevation acute coronary syndromes undergoing elective PCI can attenuate the increase in serum hs-CRP, sLox-1, CK-MB, and cTnI levels, reduce myocardial injury and inflammatory reaction caused by PCI, and improve the LVEF level at 30 days after PCI, ensuring an effective and safe therapy.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>26387028</pmid><doi>10.1007/s40261-015-0335-1</doi><tpages>8</tpages></addata></record>
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subjects Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - surgery
Aged
Aged, 80 and over
Elective Surgical Procedures - methods
Female
Gastrointestinal Diseases - chemically induced
Gastrointestinal Diseases - diagnosis
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
Original Research Article
Percutaneous Coronary Intervention - methods
Pharmacology/Toxicology
Pharmacotherapy
Rosuvastatin Calcium - administration & dosage
Treatment Outcome
title Efficacy and Safety of Loading-Dose Rosuvastatin Therapy in Elderly Patients with Acute Coronary Syndromes Undergoing Elective Percutaneous Coronary Intervention
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