急性心肌梗死后首个24h内急性应用他汀类药物可降低死亡和发生充血性心力衰竭的风险

作     者：Wright R. S. Bybee K. Miller W. L. 郭俊(译) 马超(校) 

作者机构：Division of Cardiovascular Diseases Mayo Clinic College of Medicine Mayo Clinic 200 First Street SW Rochester MN55905 United States 不详 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第8期

页      面：51-52页

学科分类：1007[医学-药学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：他汀类药物 充血性心力衰竭 急性心肌梗死后 死亡风险 急性心肌梗死(AMI) 肌酸激酶(CK) 院内死亡率 治疗患者 肌酸激酶同工酶 

摘      要：Background: Reports have demonstrated an association between statin therapy during the first day of hospitalization for acute myocardial infarction(AMI) and reduced mortality. There are little data about whether early statin therapy reduces risk of CHF and alters timing of death. Methods: We identified 3226 consecutive patients with AMI from 1993 through 2000 and divided them into early statin therapy(statins were administered within the initial 24 h of hospitalization, n=220) and non-statin therapy groups(n=3006). We compared mortality risks, rates of CHF development and measures of peak CK and CK-MB values between the groups. Results: In-hospital mortality was lower in the early statin therapy group(2.7% ) compared to the non-statin therapy group(9.2% ), p=0.001. We observed no differences in the median time to death(statin group 132 h vs. non-statin group 72 h), p=0.3. Patients with very early statin treatment had lower peak CK(624 ng/ml)and CK-MB(46 ng/ml) values compared to non-statin patients(848 ng/ml and 84 ng/ml), p 0.01. Patients in the early statin group had lower risks of developing CHF during hospitalization(10.2% ) compared to the non-statin group(25.7% ), p 0.001. Conclusion: Very early administration of statin therapy during the first day of hospitalization for AMI was associated with lower in-hospital mortality, lower rates of developing CHF and reduced peak biomarker release. These data support a benefit from early statin therapy in AMI and support the need for prospective studies which test whether very early statin therapy might also reduce infarct size.