Effect of intensive rosuvastatin on adiponection, brain natriuretic peptide and left ventricular remodeling after myocardial infarction with percutanious coronary intervention

Wu Xiangjun; Wang Qingyuan; Liu Haitao

doi:10.3760/cma.j.issn.1673-4777.2014.01.003

Abstract：Objective To explore the effect of rosuvastatin intensive treatment on adiponectin,brain natriuretic peptide and left ventricular remodeling after myocardial infarction with percutanious coronary intervention (PCI).Methods Ninety-six patients with acute myocardial infarction undergoing PCI with heart failure were selected.All 96 cases were randomly divided into control group which was treated with general therapy; the treatment group undertook rosuvastatin 10 mg/d on the basis of the general treatment; the intensive group was treated with rosuvastatin 20 mg/d based on the general treatment (32 cases in each group).The adiponectin and brain natriuretic peptide were detected on the first day,four weeks and eight weeks after surgery.Color Doppler with left ventricular remodeling indicators,including the left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF),left ventricular mass index (LVMI),diastolic interventricular septum thickness (IVST),peak E and A wave ratio and wall motion score index (WMSI) were observed.The occurrence of adverse events in hospital and outside the hospital was recorded.Results ①After therapy,the plasma adiponectin was significantly higher than that before surgery [control group:(5.9 ± 1.5),(7.1 ±1.4),(8.2 ±l.3)g/L vs (3.9 ± 1.2)g/L; treatment group:(5.7 ± 1.4),(8.3 ± 1.5),(9.6 ± 1.2)g/L vs (4.1 ± 1.0)g/L;intensive group:(5.8 ± 1.0),(9.9 ±1.7),(11.5 ± 1.1) g/L vs(4.3 ±0.9) g/L] (P＜0.05).Four weeks and eight weeks after therapy,compared with statin treatment and control groups,plasma adiponectin levels in intensive group were significantly increased (P ＜ 0.05).②After PCI,the plasma brain natriuretic peptide was significantly lower [control group:(636 ± 99),(547 ± 124),(467 ± 112) μg/L vs (746 ±102) μg/L;treatment group:(676 ± 107),(436 ± 89),(401 ± 91) μg/L vs (730 ± 142) μg/L; intensive group:(607±131),(346±67),(286±72)μg/L vs (738 ± 127)μg/L] (P＜0.05).After four weeks and eight weeks,plasma brain natriuretic peptide in intensive group was significantly lower (P ＜ 0.05).③8 weeks after PCI,LVEDD LVPWT,LVMI and WMSI were significantly lower (P ＜ 0.05),while the LVEF,IVST and the E peak/A peak were significantly higher (P ＜ 0.05).8 weeks after therapy,LVEDD,LVPWT and LVMI WMSI in intensive group were decreased (P ＜ 0.05) ; LVEF,IVST,E peak/A peak were increased (P ＜ 0.05).There were no significant differences in the rate of mortality (P ＞ 0.05).Conclusions ①Rosuvastatin statin intensive treatment can significantly increase plasma adiponectin levels and reduce plasma brain natriuretic peptide levels.It protects the coronary vascular endothelial cells and reduce the occurrence of in-stent restenosis.②Rosuvastatin intensive treatment is effective on left ventricular remodeling.③ Acute myocardial infarction in patients with early PCI on the basis of early application of rosuvastatin intensive treatment can significantly reduce PCI postoperative cardiovascular events in patients with coronary heart disease.