ABSTRACT
BACKGROUND: LDL and hs-CRP are risk factors for vascular events and can be modified by Statin. OBJECTIVE: To evaluate the baseline hs-CRP of a certain Thai population who would need Atorvastatin, to evaluate the dose response of Atorvastatin toward LDL and hs-CRP level, and to evaluate the efficacy and safety of different types of Atorvastatin. MATERIAL AND METHOD: Subjects, who needed Statin therapy, were randomized to receive either 20 mg of Berlin(B)-Atorvastatin(R) or Pfizer(P)-Atorvastatin(R). The cross over took place after 8 weeks of therapy and continued for 16 weeks. Baseline blood tests were compared to 8 and 16 weeks. The effect of two brands of 20 mg Atorvastatin toward serum lipid, LFT, muscle enzyme and hs-CRP were compared. RESULTS: One hundred and ten subjects aged between 20-75 years enrolled in the present study. Fifty-four and 56 patients were randomized to group A and B. Baseline total cholesterol, LDL, HDL, and TG were 251, 174, 55, and 160 mg/dl respectively. There was a wide variation of baseline hs-CRP level. One hundred and seven patients completed this 16 weeks study. Atorvastatin 20 mg lowered TC by 32%, LDL 44% and hs-CRP 10% at 16 weeks for the entire study (p < 0.003). The effect of either Atorvastatin the lipid profiles and hs-CRP were different. There was no significant change in LFT or muscle enzyme. CONCLUSION: Atorvastatin 20 mg has a dramatic effect on the lipid but moderate effect on CRP. The two different types of Atorvastatin (group A and B) have similar effect on both safety and efficacy.
Subject(s)
Adult , Aged , Anticholesteremic Agents/therapeutic use , C-Reactive Protein/drug effects , Cholesterol, HDL/drug effects , Cholesterol, LDL/drug effects , Female , Heptanoic Acids/therapeutic use , Humans , Hypercholesterolemia/drug therapy , Male , Middle Aged , Pyrroles/therapeutic use , Risk Factors , Thailand , Treatment OutcomeABSTRACT
A 40 year old female with severe mitral valve stenosis, underwent mitral valve replacement by single disc valve 4 years ago. She presented at this admission with a new onset of congestive heart failure. The prothrombin time was inadequate with international normalized ratio (INR) 1.43. Transthoracic echocardiography revealed high pressure gradient across the mitral valve. Fluoroscopy demonstrated restrictive opening of single disc motion. Intravenous thrombolysis was given for presumptive diagnosis of prosthetic valve thrombosis. The patient gradually improved and did not have to undergo surgical correction.