[PP.18.09] DYNAMICS OF BLOOD PRESSURE AND RIGIDITY DURING THERAPY WITH DIFFERENT DOSES OF ATORVASTATIN IN PATIENTS WITH STEMI

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Abstract

Objective:

To study the effect of different doses of atorvastatin therapy on the parameters of the central pressure and pulse wave velocity (PWV) in the aorta in patients with acute myocardial infarction with ST segment elevation (STEMI).

Design and method:

The study included 46 patients STEMI aged 35 to 65 in the first 24–96 hours of the onset of the disease. An inclusion criteria was the hemodynamically significant stenosis of one coronary artery (infarct-related artery). Patients were randomized into two groups. The control group (C) consisted of 26 patients receiving atorvastatin 20 mg/day. The main group (A) consisted of 20 people who were taking atorvastatin 80 mg/day. Initially 7–9 hours from the onset of the disease and after 24 weeks, patients underwent applanation tonometry by Sphygmocor (AtCor Medical, Australia). Analyzed parameters: central aortic systolic pressure (the SBPao), central aortic diastolic pressure (DBPao), pulse pressure (PPao), carotid-femoral PWV (cfPWV).

Results:

In patients of the group C initial values of SBP were112,7 ± 11,3 mmHg, DBP − 70 (65; 75) mmHg; after 24 weeks of treatment − 114,5 ± 12,1mmHg, and 70 (70; 75) mmHg (p > 0,05). An increase in parameters of applanation tonometry have been revealed: SBPao from 101,5 ± 10,1 to 111,3 ± 13,1 mmHg (p < 0,05), DBPao − 71 (66; 76) and 75,9 ± 10,6 mmHg (p < 0,05), PPao from 30 ± 6,7 to 35 ± 8,6 mmHg (p < 0,05). Patients of the main group had no dynamics of the office BP: initial − 118,9 ± 9,1 mmHg and 80 (65, 80) mmHg; follow-up measurements −119,4 ± 9,9 and 77,7 ± 7,9 mmHg (p > 005). The pressures in the aorta initially were: the SBPao − 105,7 ± 10,0 mmHg, DBPao − 81 (65.5; 82) mmHg, PPao − 29,5 ± 8,5 mmHg; after 24 weeks of therapy with high doses of atorvastatin − 111,5 (104,5, 123) mmHg (p < 0,05), 78,5 ± 8,8 mmHg (p > 0.05), and 33,1 ± 7,4 mmHg (p > 0,05). Baseline values of cfPWV in patients group C were 8,5 ± 2,4 m/s, follow-up − 9,4 ± 2,4 m/s (p > 0,05); patients in group A − 9,0 ± 1,9, and 8,3 ± 1,4 m/s, respectively (p < 0,05).

Conclusions:

Atorvastatinat high doses in patients with STEMI is accompanied by better control of the central (aortic) pressure parameters, and decrease of aortic PWV.

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