Effect of trimetazidine and atorvastatin on coronary no or slow flow phenomenon after emergency percutaneous coronary intervention / 中国综合临床

ABSTRACT

Objective To investigate the therapeutic effect of trimetazidine(TMZ) and atorvastatin on coronary no-flow/slow-flow phenomenon (CNFP/CSFP) emergency pereutaneous coronary intervention (PCI)Methods Thirty-two patients with acute myocardial infarction were selected as our subjects,who hospitalized from April 2007 to May 2012 after PCI with CNFP/CSFP.Patients were administrated with the TMZ (60 mg/d)and atorvastatin (20 mg/d) for 6 months besides the routine therapy.The changes of the clinical symptoms including ECG exercise test,coronary flow of coronary angiography(CAG) were recorded and the level of serum high sensitivity C-reactive protein (hs-CRP),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) were measured before and after the treatment.Results (1)The symptoms of the patients were improved remarkably;the effective rate was 87.5％ (28/32).The improving rate of ECG was 90.6％.The CTFC of patients after treatment was (20.17 ± 4.36),significantly lower than that of before treatment (35.34 ± 7.43,t =2.409,P ＜ 0.05).(2) The levels of hs-CRP,MMP-9,TNF-a and IL-6 at after treatment were (3.34 ±0.47) mg/L,(173.09 ±42.19) μg/L,(8.47 ±2.09) μg/L,(89.37 ± 18.72) ng/L,lower than that of before treatment ((12.34 ± 2.43) mg/L,(972.68 ± 131.91) μg/L,(23.54 ± 7.48) μg/L,(154.39 ± 42.07) ng/L),and difference were significant (t =2.537,2.789,2.691,2.430,P ＜ 0.01 or P ＜0.05).Conclusion The therapy approach of TMZ and atorvastatin plus routine treatment of nitrate and aspirin showed a better therapeutic effect on CNFP/CSFP.The causes of CNFP/CSFP may relate to inflammation.