The introduction of percutaneous coronary intervention (PCI) substantially changed the treatment of patients with coronary artery disease. Stent thrombosis is the most worrisome early complication in patients undergoing PCI. Therefore, antiplatelet therapy forms an integral component of treatment with intracoronary stent implantation. A multitude of randomized and observational studies have helped identify and define the role of clopidogrel in today's PCI patient. Although much is known about its use, a number of questions still remain.

• MeSH
• balónková koronární angioplastika škodlivé účinky   MeSH
• elektivní chirurgické výkony MeSH
• lidé MeSH
• nemoci koronárních tepen farmakoterapie   chirurgie   MeSH
• pooperační komplikace etiologie   prevence a kontrola   MeSH
• předoperační péče metody   MeSH
• randomizované kontrolované studie jako téma metody   MeSH
• tiklopidin analogy a deriváty   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Percutaneous coronary intervention (PCI)-related myonecrosis is frequent and can affect the long-term prognosis of patients. To our knowledge, ticagrelor has not been evaluated in elective PCI and could reduce periprocedural ischaemic complications compared with clopidogrel, the currently recommended treatment. The aim of the ALPHEUS study was to examine if ticagrelor was superior to clopidogrel in reducing periprocedural myocardial necrosis in stable coronary patients undergoing high-risk elective PCI. METHODS: The ALPHEUS study, a phase 3b, randomised, open-label trial, was done at 49 hospitals in France and Czech Republic. Patients with stable coronary artery disease were eligible for the study if they had an indication for PCI and at least one high-risk characteristic. Eligible patients were randomly assigned (1:1) to either ticagrelor (180 mg loading dose, 90 mg twice daily thereafter for 30 days) or clopidogrel (300-600 mg loading dose, 75 mg daily thereafter for 30 days) by use of an interactive web response system, and stratified by centre. The primary outcome was a composite of PCI-related type 4 (a or b) myocardial infarction or major myocardial injury and the primary safety outcome was major bleeding, both of which were evaluated within 48 h of PCI (or at hospital discharge if earlier). The primary analysis was based on all events that occurred in the intention-to-treat population. The trial was registered with ClinicalTrials.gov, NCT02617290. FINDINGS: Between Jan 9, 2017, and May 28, 2020, 1910 patients were randomly assigned at 49 sites, 956 to the ticagrelor group and 954 to the clopidogrel group. 15 patients were excluded from the ticagrelor group and 12 from the clopidogrel group. At 48 h, the primary outcome was observed in 334 (35%) of 941 patients in the ticagrelor group and 341 (36%) of 942 patients in the clopidogrel group (odds ratio [OR] 0·97, 95% CI 0·80-1·17; p=0·75). The primary safety outcome did not differ between the two groups, but minor bleeding events were more frequently observed with ticagrelor than clopidogrel at 30 days (105 [11%] of 941 patients in the ticagrelor group vs 71 [8%] of 942 patients in the clopidogrel group; OR 1·54, 95% CI 1·12-2·11; p=0·0070). INTERPRETATION: Ticagrelor was not superior to clopidogrel in reducing periprocedural myocardial necrosis after elective PCI and did not cause an increase in major bleeding, but did increase the rate of minor bleeding at 30 days. These results support the use of clopidogrel as the standard of care for elective PCI. FUNDING: ACTION Study Group and AstraZeneca.

• MeSH
• antagonisté purinergních receptorů P2Y terapeutické užití   MeSH
• elektivní chirurgické výkony MeSH
• inhibitory agregace trombocytů * škodlivé účinky   terapeutické užití   MeSH
• klopidogrel škodlivé účinky   terapeutické užití   MeSH
• koronární angioplastika škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ticagrelor terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: The safety and efficacy of antithrombotic regimens may differ between patients with atrial fibrillation who have acute coronary syndromes (ACS), treated medically or with percutaneous coronary intervention (PCI), and those undergoing elective PCI. METHODS: Using a 2×2 factorial design, we compared apixaban with vitamin K antagonists and aspirin with placebo in patients with atrial fibrillation who had ACS or were undergoing PCI and were receiving a P2Y12 inhibitor. We explored bleeding, death and hospitalization, as well as death and ischemic events, by antithrombotic strategy in 3 prespecified subgroups: patients with ACS treated medically, patients with ACS treated with PCI, and those undergoing elective PCI. RESULTS: Of 4614 patients enrolled, 1097 (23.9%) had ACS treated medically, 1714 (37.3%) had ACS treated with PCI, and 1784 (38.8%) had elective PCI. Apixaban compared with vitamin K antagonist reduced International Society on Thrombosis and Haemostasis major or clinically relevant nonmajor bleeding in patients with ACS treated medically (hazard ratio [HR], 0.44 [95% CI, 0.28-0.68]), patients with ACS treated with PCI (HR, 0.68 [95% CI, 0.52-0.89]), and patients undergoing elective PCI (HR, 0.82 [95% CI, 0.64-1.04]; Pinteraction=0.052) and reduced death or hospitalization in the ACS treated medically (HR, 0.71 [95% CI, 0.54-0.92]), ACS treated with PCI (HR, 0.88 [95% CI, 0.74-1.06]), and elective PCI (HR, 0.87 [95% CI, 0.72-1.04]; Pinteraction=0.345) groups. Compared with vitamin K antagonists, apixaban resulted in a similar effect on death and ischemic events in the ACS treated medically, ACS treated with PCI, and elective PCI groups (Pinteraction=0.356). Aspirin had a higher rate of bleeding than did placebo in patients with ACS treated medically (HR, 1.49 [95% CI, 0.98-2.26]), those with ACS treated with PCI (HR, 2.02 [95% CI, 1.53-2.67]), and those undergoing elective PCI (HR, 1.91 [95% CI, 1.48-2.47]; Pinteraction=0.479). For the same comparison, there was no difference in outcomes among the 3 groups for the composite of death or hospitalization (Pinteraction=0.787) and death and ischemic events (Pinteraction=0.710). CONCLUSIONS: An antithrombotic regimen consisting of apixaban and a P2Y12 inhibitor without aspirin provides superior safety and similar efficacy in patients with atrial fibrillation who have ACS, whether managed medically or with PCI, and those undergoing elective PCI compared with regimens that include vitamin K antagonists, aspirin, or both. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02415400.

• MeSH
• akutní koronární syndrom komplikace   farmakoterapie   chirurgie   MeSH
• antagonisté purinergních receptorů P2Y škodlivé účinky   terapeutické užití   MeSH
• antikoagulancia škodlivé účinky   terapeutické užití   MeSH
• Aspirin terapeutické užití   MeSH
• elektivní chirurgické výkony MeSH
• fibrilace síní komplikace   farmakoterapie   MeSH
• fibrinolytika škodlivé účinky   terapeutické užití   MeSH
• hospitalizace MeSH
• inhibitory agregace trombocytů škodlivé účinky   terapeutické užití   MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• kombinovaná farmakoterapie MeSH
• kombinovaná terapie MeSH
• koronární angioplastika * MeSH
• krvácení chemicky indukované   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• management nemoci MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• pyrazoly terapeutické užití   MeSH
• pyridony terapeutické užití   MeSH
• senioři MeSH
• vitamin K antagonisté a inhibitory   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze IV MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

Kontext: Periprocedurální poškození myokardu a jeho význam pro klinickou praxi u stabilizovaných pa- cientů je stále předmětem diskuse. Tímto tématem se za celé roky zabývala řada studií s různými definicemi, prahovými hodnotami a biomarkery. Cílem naší studie bylo popsat výsledný klinický stav pacientů s periprocedurálním poškozením myokardu pomocí definic nejnovějších, 4. doporučených postupů UDMI. Metody: Do monocentrické studie bylo retrospektivně zařazeno 238 pacientů po elektivní perkutánní koronární intervenci. Pacienti s periprocedurálním poškozením myokardu byli po výkonu srovnáni s pacienty s normálními hodnotami troponinu z hlediska výsledného klinického stavu. Mezi primární sledované parametry patřily úmrtí, infarkt myokardu, cévní mozková příhoda, refrakterní angina pectoris, revaskularizace cílové léze a hospitalizace pro akutní koronární syndrom do jednoho roku. Výsledky: Periprocedurální poškození myokardu bylo zjištěno u 67,2 % (n = 160) pacientů. Počty lézí a stentů, celková délka stentů, celkový průměr stentů, stav po dilataci, počty překrývajících se stentů, stenty na bifurkacích a skóre SYNTAX byly statisticky významně vyšší ve skupině s poškozením myokardu. Uvedené sledované parametry se vyskytly u 16 pacientů (11 ve skupině s poškozením myokardu a 5 v kontrolní skupině). Během sledování nedošlo k žádnému úmrtí. Poprocedurální zvýšení hodnot troponinu nebylo nijak spojeno se sledovanými parametry (11 vs. 5; p = 0,56). V Kaplanově-Meierově analýze se křivky sledovaných parametrů v obou skupinách od sebe nevzdalovaly (log rank test; 95% interval spolehlivosti [CI], p = 0,71). Závěry: Velikost a délka stenu, dilatace po výkonu, překrývání stentů a implantace stentů do lézí v bifurkacích zvyšují riziko poškození myokardu. Periprocedurální poškození myokardu u stabilní anginy pectoris nelze použít k predikci výsledného stavu pacienta po jednom roce.

Background: Periprocedural myocardial injury and its clinical significance in stable patients are still under discussion. This subject has been assessed in many studies with different definitions, thresholds, and biomarkers for years. This study aimed to determine the clinical outcomes of periprocedural myocardial injury based on latest 4th UDMI guideline definitions. Methods: 238 patients who underwent elective percutaneous coronary intervention at single center were retrospectively enrolled. Patients who developed periprocedural myocardial injury were compared with patients with normal troponin values after the procedure for clinical outcomes. Primary clinical endpoints were death, MI, stroke, refractory angina, target vessel revascularization and hospitalization due to acute coronary syndrome at one year. Results: Periprocedural myocardial injury was observed in 67.2% (n = 160) of patients. Number of lesions and stents, total stent length, total stent diameter, post-dilatation, overlapping stents, bifurcation stenting and SYNTAX score were significantly higher in myocardial injury group. Clinical outcomes occurred in 16 patients, 11 of 16 had myocardial injury group, 5 of 16 had control group. No mortality was seen during the follow-up. Postprocedural troponin elevation was not associated with clinical outcomes (11 vs. 5, p = 0,56). Kaplan-Meier curve of clinical end points did not show any separation between the curves (Log rank test, 95% CI, p = 0,71). Conclusion: Stent size and length, post-dilatation, overlapping stents and stenting of bifurcation lesions lead to increase in myocardial injury. Periprocedural myocardial injury in stable angina does not predict clinical outcomes at one year.

• MeSH
• Kaplanův-Meierův odhad MeSH
• koronární angioplastika MeSH
• lidé středního věku MeSH
• lidé MeSH
• poranění srdce * epidemiologie   etiologie   komplikace   MeSH
• senioři MeSH
• stabilní angina pectoris * komplikace   MeSH
• statistika jako téma MeSH
• troponin analýza   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH

Several randomized studies and meta-analyses have suggested that pretreatment with statins may decrease periprocedural myocardial infarction (MI) in patients undergoing percutaneous coronary intervention (PCI). The purpose of this randomized study was to investigate the effect of a 2-day atorvastatin therapy before PCI on long-term clinical outcome. Two hundred statin-naive patients with stable angina pectoris referred for PCI were enrolled and randomized (ratio 1:1) to 2-day pretreatment with atorvastatin 80 mg/day and subsequent PCI (atorvastatin group), or immediate PCI (control group). The registry group comprised 182 consecutive patients on long-term statin therapy referred for immediate PCI during the same period as randomized patients. We compared the first occurrence of MI or death during long-term follow-up. There were no significant differences in most clinical characteristics and early results among the 3 groups. Median follow-up was 45 months (1 to 59). Incidences of death/MI were 11.4%, 12.9%, and 13.8% in the atorvastatin, control, and registry groups, respectively. In the same groups, age-adjusted estimated 4-year freedom from death/MI was 0.78 versus 0.75 versus 0.80, respectively (p=0.882, log-rank test). In multivariate analysis, only age of patients (odds ratio 1.04, 95% confidence interval 1.02 to 1.07, p<0.001) was identified as a significant predictor of death or MI during follow-up. In conclusion, these results suggest that 2-day therapy with high-dose atorvastatin before PCI did not influence occurrence of periprocedural MI or long-term clinical outcomes.

• MeSH
• angina pectoris farmakoterapie   terapie   MeSH
• balónková koronární angioplastika MeSH
• dospělí MeSH
• kyseliny heptylové aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pyrroly aplikace a dávkování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• statiny aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

PURPOSE: The aim was to identify factors that influence the efficacy of 600 mg of clopidogrel pretreatment in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention. METHODS: In a laboratory substudy of the PRAGUE-8 trial, the influences of nonmodifiable (age and sex) and modifiable (body mass index and tobacco smoke) factors, comorbidity (hypertension, hyperlipidemia, diabetes mellitus, and renal insufficiency) and cotherapy (statin, aspirin, and heparin), on the course of clopidogrel efficacy were investigated in 105 patients pretreated with clopidogrel >or=6 hours before coronary angiography +/- percutaneous coronary intervention. Flow cytometric analysis of the vasodilator-stimulated phosphoprotein phosphorylation state was used. Independent predictors that influenced clopidogrel action were identified using linear regression. RESULTS: There was no correlation between baseline platelet reactivity index (PRI) and severity of coronary atherosclerosis; mean index of platelet reactivity for a nonsignificant lesion was 72% +/- 5.98% and for a significant lesion 70.08% +/- 8.43%. The highest proportion of low responders was patients with diabetes (50% at 28 hours). Among tobacco smokers, the response to clopidogrel occurred quickly and 80% of smokers had effective inhibition of PRI, 12 hours after drug use. After adjustments, tobacco smoking was an independent predictor for the most robust drop of PRI 12 hours after clopidogrel (P = 0.027). The magnitude of total decrease of PRI at 28 hours was not significantly influenced by cigarette smoking (P = 0.12). Linear regression showed that patients on statin therapy had a better response to clopidogrel than those without statins-the mean decrease of PRI at 28 hours was significantly higher (P = 0.02) among these patients (40.0 vs. 27.6). CONCLUSIONS: In stable coronary artery disease, no correlation exists between baseline PRI and the severity and extent of coronary atherosclerosis. A high loading dose of clopidogrel does not satisfactorily suppress enhanced PRI in patients with diabetes. Cigarette smoking is independently associated with a prompt antiplatelet response to clopidogrel. Ongoing statin therapy is an independent determinant of more effective clopidogrel-mediated inhibition of platelet reactivity.

• MeSH
• Aspirin terapeutické užití   MeSH
• balónková koronární angioplastika MeSH
• diabetes mellitus 2. typu komplikace   patofyziologie   MeSH
• fosfoproteiny metabolismus   MeSH
• heparin terapeutické užití   MeSH
• hypercholesterolemie epidemiologie   patofyziologie   MeSH
• hypertenze komplikace   patofyziologie   MeSH
• index tělesné hmotnosti MeSH
• inhibitory agregace trombocytů aplikace a dávkování   terapeutické užití   MeSH
• kombinovaná farmakoterapie MeSH
• koronární angiografie MeSH
• kouření škodlivé účinky   MeSH
• lidé MeSH
• mikrofilamentové proteiny metabolismus   MeSH
• molekuly buněčné adheze metabolismus   MeSH
• nemoci koronárních tepen farmakoterapie   komplikace   radiografie   terapie   MeSH
• renální insuficience komplikace   patofyziologie   MeSH
• senioři MeSH
• sexuální faktory MeSH
• statiny terapeutické užití   MeSH
• tiklopidin analogy a deriváty   aplikace a dávkování   terapeutické užití   MeSH
• věkové faktory MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

Zavedení perkutánních koronárních intervencí (PCI) do rutinní léčby znamenalo zásadní pokrok ve snížení mortality a zlepšení kvality života pacientů se stabilní anginou pectoris (SAP) nebo s akutním infarktem myokardu (AIM). Je možné, že jsme dnes svědky dalšího obrovského skoku v invazivní kardiologii použitím radiálního přístupu místo tradičního femorálního přístupu. Radiální cesta, kterou v roce 1989 poprvé použil v diagnostice ischemické choroby srdeční (ICHS) dr. Campeau, snižuje riziko krvácení a následně i celkovou mortalitu pacientů s AIM, zvláště pokud ji použijí zkušení a zruční operatéři. Předkládáme seriózní přehled údajů ze srovnání radiálního a femorálního přístupu z polského pohledu v naději, že by toto srovnání mohlo být užitečné pro invazivní a neinvazivní kardiology v jejich každodenní praxi.

A crucial progress in reduction of mortality and improvement of quality of life in patients with either stable angina (SA) or acute myocardial infarction (AMI) has been made by introduction of percutaneous coronary intervention (PCI) in daily treatment. Possibly we are witnessing another giant leap in invasive cardiology by the use of radial instead of traditional femoral approach. Radial route which was firstly introduced in diagnostic of coronary heart disease (CHD) by Dr. Campeau in 1989 reduces the risk of bleedings and subsequently overall mortality in patients with AMI, especially when used by experienced and skilled operators. We present a critical review of data comparing radial to femoral approach seen from the Polish perspective hoping it could be useful for invasive and non-invasive cardiologists in their everyday practice.

• MeSH
• arteria radialis * chirurgie   MeSH
• balónková koronární angioplastika * metody   škodlivé účinky   MeSH
• dávka záření MeSH
• lidé MeSH
• pracovní expozice MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Whether ticagrelor in chronic coronary syndrome patients undergoing complex percutaneous coronary intervention (PCI) can prevent cardiovascular events is unknown. OBJECTIVES: The authors sought to evaluate outcomes of complex PCI and the efficacy of ticagrelor vs clopidogrel in stable patients randomized in the ALPHEUS (Assessment of Loading with the P2Y12 inhibitor ticagrelor or clopidogrel to Halt ischemic Events in patients Undergoing elective coronary Stenting) trial. METHODS: All PCI procedures were blindly reviewed and classified as complex if they had at least 1 of the following criteria: stent length >60 mm, 2-stent bifurcation, left main, bypass graft, chronic total occlusion, use of atherectomy or guiding catheter extensions, multiwire technique, multiple stents. The primary endpoint was a composite of type 4a or b myocardial infarction (MI) and major myocardial injury during the 48 hours after PCI. We compared the event rates according to the presence or not of complex PCI criteria and evaluated the interaction with ticagrelor or clopidogrel. RESULTS: Among the 1,866 patients randomized, 910 PCI (48.3%) were classified as complex PCI. The primary endpoint was more frequent in complex PCI (45.6% vs 26.6%; P < 0.001) driven by higher rates of type 4 MI and angiographic complications (12.2% vs 4.8 %; P < 0.001 and 19.3% vs 8.6%; P < 0.05, respectively). The composite of death, MI, and stroke at 48 hours (12.7% vs 5.1 %; P < 0.05) and at 30 days (13.4% vs 5.3%; P < 0.05) was more frequent in complex PCI. No interaction was found between PCI complexity and the randomized treatment for the primary endpoint (Pinteraction = 0.47) nor the secondary endpoints. CONCLUSIONS: In chronic coronary syndrome, patients undergoing a complex PCI have higher rates of periprocedural and cardiovascular events that are not reduced by ticagrelor as compared with clopidogrel.

• MeSH
• akutní koronární syndrom * diagnostické zobrazování   terapie   komplikace   MeSH
• infarkt myokardu * etiologie   MeSH
• inhibitory agregace trombocytů škodlivé účinky   terapeutické užití   MeSH
• klopidogrel škodlivé účinky   terapeutické užití   MeSH
• koronární angioplastika * škodlivé účinky   MeSH
• lidé MeSH
• ticagrelor škodlivé účinky   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Ischemia modified albumin (IMA) is a new biochemical marker of ischemia. IMA levels rise in patients who develop ischemia during percutaneous coronary intervention (PCI). It is unclear whether IMA elevations correlate with PCI variables. The possible prognostic value of post-PCI IMA elevation has not yet to be studied. METHODS: We studied 60 patients (mean age 61 years; 51 male) who underwent successful elective single-vessel PCI for the management of stable angina pectoris. IMA levels were measured and compared with PCI variables and target lesion revascularization rate. The median post-PCI follow up is 46 months (CI 44.6 to 47.7). RESULTS: We found that the only variable related to post-PCI IMA levels was periprocedural dissection of target vessel (147.6 vs. 141.1 kU/l, p=0.035). No correlation between high and low balloon inflation pressure (143.6 vs. 141.6 kU/l, p=0.64), short and long inflation pressure (141.5 vs. 143.6 kU/l, p=0.17), with and without stent placement (143.7 vs. 141.3 kU/l, p=0.93) was found. IMA level more then 130 kU/l was associated with higher frequency of target lesion revascularization at nearly 4-years follow-up (p=0.026). CONCLUSION: Post-PCI IMA elevation is associated with higher target lesion revascularization.

• MeSH
• albuminy metabolismus   MeSH
• balónková koronární angioplastika MeSH
• financování organizované MeSH
• ischemie diagnóza   krev   metabolismus   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• patologická angiogeneze krev   patologie   MeSH
• prognóza MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

Both randomized and observational studies have suggested that pretreatment with statins may reduce the incidence of periprocedural myocardial infarction (PMI) in patients with stable angina during elective percutaneous coronary intervention (PCI). The purpose of this randomized study (Clinical Trial Registration No. NCT00469326) was to investigate the effect of 2-day atorvastatin therapy on the incidence of PMI in patients with stable angina pectoris undergoing elective PCI. A total of 200 patients with stable angina pectoris who were not taking statins and who had been referred for PCI were enrolled and randomized (ratio 1:1) to a 2-day pretreatment regimen with atorvastatin 80 mg/day and subsequent PCI or immediate PCI. The serum concentration of creatine kinase-MB mass and troponin I were measured before and 16 to 24 hours after PCI. The incidence of PMI was assessed using established criteria. Of the patients, 10% in the atorvastatin group and 12% in the control group had a postprocedural creatine kinase-MB mass elevation > or =3 times the upper limit of normal (p = 0.65). The incidence of PMI as determined by the postinterventional release of troponin I > or =3 times the upper limit of normal was 17% in the atorvastatin group and 16% in the control group (p = 0.85). The median creatine kinase-MB mass peak after PCI was 1.46 ng/ml (interquartile range 0.83 to 2.52) in the atorvastatin group and 1.40 ng/ml (interquartile range 0.90 to 2.54) in the control group (p = 0.70). The median peak troponin I level after PCI was 0.100 ng/ml (0.096 to 0.385) in the atorvastatin group and 0.100 ng/ml (0.60 to 0.262) in the control group (p = 0.54). On multivariate analysis, the only independent predictor of PMI was patient age (odds ratio 1.09, 95% confidence interval 1.025 to 1.159, p = 0.006). In conclusion, in the present study 2-day pre-PCI therapy with atorvastatin did not reduce the occurrence of PMI in patients with stable angina pectoris undergoing elective PCI.

• MeSH
• angina pectoris terapie   MeSH
• dospělí MeSH
• infarkt myokardu prevence a kontrola   MeSH
• kyseliny heptylové aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• multivariační analýza MeSH
• prospektivní studie MeSH
• pyrroly aplikace a dávkování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• statiny aplikace a dávkování   MeSH
• troponin I krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH