ABSTRACT
Objective To explore the status quo of intensive statin therapy in hospitalized patients with acute myocardial infarction (AMI) from 2001 to 2011 and analyze its influence factors.Methods We obtained in-formation of AMI patients in 2001,2006,and 2011 from their medical record. Intensive statin therapy was defined as statin regiments with expected LDL-C lowering of at least 40%.Results Among 767 patientswith definite dosage of statin,the use frequencyof intensive statin increased from 0%in 2001 to 60.77% in 2006,and 88.71% in 2011 (P0.05). Conclusions The use frequency of intensive stain therapy among AMI patientsincreasesyear by year and it is affected by sex,risk factors,history of disease and type of infarction.
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Objective To observe the bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting. Methods A total of 240 patients treated with coronary artery bypass grafting were randomly divided into group A(experimental group)and group B(control group). All pa-tients were normalized to conventional treatment and they were given low molecular weight heparin for an-ticoagulant therapy during the perioperative period. Patients in group A were given 40 mg of atorvastatin before surgery,and 40 mg of atorvastatin every night for one month after the surgery. Patients in group B were given 10 mg of atorvastatin every night during the treatment. One month after the operation,platelet aggregation rate and bleeding events of patients were compared. Results There were significant differ-ences in maximum platelet aggregation rate[(14. 5 ± 3. 7)% vs(38. 1 ± 7. 4)% ,P < 0. 05],inhibition rate of platelet aggregation[(79. 5 ± 4. 3)% vs(50. 8 ± 10. 2)% ,P < 0. 05],and incidence of postopera-tive bleeding[27. 5% vs 12. 5% ,P < 0. 05]between group A and B,respectively. Conclusion Short-term intensive statin therapy can increase the bleeding risk after coronary artery bypass grafting.
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Objective To analyze quantitatively the safety and efficacy of statin therapy in acute phrase for acute ischemic stroke with the method of meta-analysis.Methods We performed a systematic literature search including the Cochrane Library,MEDLINE and EMBASE for published trials about statin therapy and the outcomes of acute ischemic stroke.Then we performed a meta-analysis with included studies to investigate the association between statin therapy and clinical outcome and mortality.All of the data were pooled and meta-analyzed by Cochrane Collaboration RevMan 5.3 meta-analysis software.Statistical heterogeneity between studies was evaluated by the chi-square and I-square tests.Forest plots were used to summarize study data and Egger tests were used to assess publication bias.Results A total of 27 studies including 52 034 patients,comprising 19 212 statin users and 32 822 non-statin users met the inclusion criteria,4 studies were randomized controlled trials (RCTs),and 23 were observational trials (OTs).Both pre-or post-stroke statin use was associated with reduced mortality.Statin use is associated with favorable functional outcome at hospital discharge and on the ninetieth day regardless of initiation time for pre-stroke group and post-stroke group.The results from observational trials were consistent with randomized controlled trials.There was no evidence of publication bias for all comparisons by Egger tests.Conclusions Statin therapy before or after AIS is safe and effective.
ABSTRACT
Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (<1% per year) risk of a MACE. In addition to preventing myocardial infarction (MI), stroke, and death, primary prevention with statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians.