Protective effect of spironolactone on myocardium during perioperation period of percataneous coronary intervention / 第二军医大学学报

ABSTRACT

Objective To investigate the protective mechanism of spironolactone pretreatment on myocardium during perioperation period of percataneous coronary interventional (PCI). Methods A total of 237 patients who under went PCI during Jun. 2007 to Dec. 2010 in People's Hospital of Rugao County were included in the present study. The patients were randomly divided into two groups treatment group (n=116) and control group (n=121). Patients in the treatment group were given spironolactone (20-40 mg/d) and those in the control group were given placebo. The mean arterial pressure in root of aorta (MAPA), concentrations of aldosterone, troponin I(cTn-I), brain natriuretic peptide (BNP) and c-reaction protein (CRP) were determined before and after PCI. All the data were analyzed by SPSS 11. 5 software system. Results There were no significant differences in the age, sex, operation time, times of balloon and number of stents between the two groups. The concentrations of Aldo, cTn-I, BNP and CRP were greatly increased in the two groups after operation. The concentrations of the Aldo were similar between the two groups before and after PCI; the concentrations of cTn-I, CRP and BNP in treatment group were significantly lower than those in the control group (P<0.05) and the MAPA was higher than that in the control group. We also found that ΔMAPA (postoperative MAPA-preoperative MAPA)was negatively correlated with ΔcTn-I(postoperative cTn-I/preoperativec Tn-I), ΔCRP(postoperative CRP/preoperative CRP), and ΔBNP(postoperative BNP/preoperative BNP), with the coefficients being-0.69, -0.51 and- 0.56 (P<0.05 or P<0.01). Conclusion Pretreatment with spironolactone can alleviate myocardial injury, inhibit inflammatory reaction and relieve heart failure in perioperative period of PCI, which might be related to spironolactone-Induced myocardial perfusion.