Perioperative antithrombotic treatment is an independent risk factor of postoperative bleeding complications in patients with gastric cancer undergoing radical gastrectomy, although such treatment was effective in preventing postoperative thromboembolic events.

levation of cardiac biomarkers has been shown to occur in 5-40% of cases after otherwise successful percutaneous coronary intervention (PCI). 1-3 Even mild myocardial damage with elevation of cardiac troponin T (TnT) or creatine kinase myocardial isozyme (CK-MB) is associated with increased risk of subsequent cardiac events, [3][4][5][6][7] and several strategies have been proposed to address this issue. [8][9][10][11] Hydroxy-3-methylglutaryl co-enzyme A reductase inhibitors (statins) reportedly reduce myocardial injury during PCI and subsequent cardiovascular events. [12][13][14][15][16][17] With the current wide use of drug-eluting stents to provide full coverage of coronary lesions, longer stents are necessary to prevent re-stenosis and thus more myocardial injury may occur during PCI with stenting. We performed a randomized controlled study of patients with stable angina to compare periprocedural myocardial damage with intensive or moderate lipid-lowering intervention before PCI Methods Patient PopulationBetween January 2004 and June 2005, a total of 42 patients scheduled for elective PCI of a de novo lesion and with no history of statin use were randomly assigned to receive either intensive lipid-lowering therapy (Group A; n=21) or moderate lipid-lowering therapy (Group B; n=21). Patients with stable angina were selected and coronary angiography was performed before the statin therapy. Patients who had a myocardial infarction (MI), or previous PCI, bypass surgery, multivessel disease or renal dysfunction were excluded. All study protocols were approved by the Ethics Committee of Shizuoka Municipal Shimizu Hospital, and all patients gave written informed consent. Lipid-Lowering ProtocolsGroup A patients were treated with atorvastatin (5-20 mg) to reach a target low-density lipoprotein-cholesterol (LDL-C) level of <70 mg/dl. Group B patients were treated using the same agent to reach LDL-C <100 mg/dl. Statin therapy was performed for ≥2 weeks before PCI to reach the target LDL-C levels. Coronary InterventionSirolimus Background Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy. Methods and ResultsSubjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C) <70 mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C <100 mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial dama...

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