Effect of loading dose atorvastatin on postoperative cardiovascular events in elderly patients with acute myocardial infarction undergoing percutaneous coronary intervention.

Abstract

Objective: To evaluate the effects of loading-dose atorvastatin on cardiac function, lipid metabolism, inflammatory response, and cardiovascular events in elderly patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).

Methods: A retrospective analysis was conducted on 128 elderly patients with AMI (≥60 years) who underwent PCI. Patients were divided into a loading-dose group (group A; 40-80 mg loading dose, n=71) and a conventional-dose group (group B; 20 mg or without a loading dose, n=57). Cardiac functionindices, including cardiac output, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), lipid profiles (total cholesterol [TC], triglyceride [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C]), and inflammatory markers (C-reactive protein [CRP], procalcitonin [PCT]) were compared between the two groups before and after treatment. Major adverse cardiovascular events [MACEs] within 3 months after PCI and medication safety were also evaluated.

Results: After treatment, cardiac output, LVEF, and HDL-C levels were significantly increased, while LVEDD, CRP, PCT, TC, TG, and LDL-C levels were significantly decreased in both groups, with significantly greater improvements observed in group A compared to group B (all P<0.05). The incidence of MACEs was significantly lower in group A than in group B (12.7% vs. 28.1%, P=0.027). No serious adverse drug reactions occurred in either group.

Conclusion: Loading-dose atorvastatin can improve cardiac function, regulate lipid metabolism, suppress inflammatory responses, and reduce the incidence of short-term MACE in elderly AMI patients after PCI, while demonstrating good safety and clinical application value.