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Objective To study the effect of intensive atorvastatin therapy on blood glucose in ACS patients.Methods Two hundred ACS patients were divided into control group (n=100) and intensive atorvastatin therapy group (n=100).The patients in both groups underwent secondary preventive treatment of CHD.The patients in control group were treated with 20 mg oral atorvastatin before going to bed and those in intensive atorvastatin therapy group were treated with 40mg oral atorvastatin.The patients were followed up for 6 months,during which their serum levels of FPG,HbA1c,TC,TG,LDL-C and HDL-C were measured before and after treatment.Results The serum levels of HDL-C were significantly higher while those of TC,TG and LDL-C were significantly lower in control group after treatment than before treatment (P＜0.01).The serum levels of HDL-C,FPG and HbA1c were significantly higher while those of TC,TG and LDL-C were significantly lower in intensive atorvastatin therapy group after treatment than before treatment(P＜0.05,P＜0.01).The serum levels of HDL-C,FPG and HbA1c were significantly higher while those of TC and LDL-C were significantly lower in intensive atorvastatin therapy group after treatment than before treatment (1.48±0.39 mmol/L vs 1.36±0.20 mmol/L,P＜0.05;5.71±0.67 mmol/L vs 5.21±0.53 mmol/L,P＜0.01;5.44％±0.75％ vs 5.19％±0.31％,P＜0.01).Conclusion Intensive statin therapy can effectively reduce the serum lipid level,elevate the serum FPG level,and increase the risk of diabetes in ACS patients.
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Objective To study the effect of combined atorvastatin and ezetimibe pretreatment on perioperative hs-CRP after elective PCI.Methods One hundred and fifty-six patients with typical chronic stable angina pectoris were randomly divided into atorvastatin treatment group (n=78) and combined atorvastatin and ezetimibe treatment group (n=78).Their serum hs-CRP,TC and LDL-C level was measured before PCI,at hours 8,24,48 and on day 7 after PCI.Results In comparision with pre-operation,the serum TC and LDL-C levels were significantly lower in two groups (P＜0.01) and in combined atorvastatin and ezetimibe treatment group than in atorvastatin treatment group on day 7 after PCI (P＜0.05).The serum hs-CRP level was significantly higher in two groups at 8 h after PCI than before PCI,reached its peak at 24 h after PCI,continued to increase at 48 h after PCI (P＜0.01),no significant difference was found between the two groups on day 7 after PCI (P＞0.05).The average serum hs-CRP level was lower in combined atorvastatin and ezetimibe treatment group than in atorvastatin treatment group at hours 8,24 and 48 after PCI (P＜0.05) with no significant change found between the two groups on day 7 after PCI (P＞0.05).Conclusion The effect of combined atorvastatin and ezetimibe pretreatment is better than that of atorvastatin alone on perioperative acute inflammatory reactions after PCI.
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Objective To study the effect of telmisartan combined with rosuvastatin on white matter lesion (WML) in elderly hypertensive patients.Metheds Three hundred and twenty-nine elderly patients with mild-moderate essential hypertension (EH) were divided into control group (n=167) and combined treatment group (n=162).The patients in control group were treated with telmisartan (40 mg/d) and those in combined treatment group were treated with telmisartan plus rosuvastatin (10 mg/d).Their white matter hyperintensivity (WMH),periventricular white matter hyperintensity (PWMH),and deep white matter hyperintensity (DWMH) were measured by head MRI.Results The total WMH,PWMH and DWMH were significantly higher in two groups in the third and fifth years than at the baseline (P＜0.05).The growth rate of total WMH,PWMH and DWMH was significantly lower in combined treatment group than in control group in the third and fifth years (P＜0.05).Conclusion Telmisartan combined with rosuvastatin plays an important role in stablizing blood pressure,regulating blood lipids,and delaying WML.
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Objective To study the role of dynamic contrast enhanced MRI (DCE-MRI) in assessing early curative effect of rosuvastatin on carotid atherosclerotic plaques.Methods Twenty-five patients with lipid-rich necrotic core carotid atherosclerotic plaques received intensive rosuvastatin treatment (5-20 mg/d) for 2 years,and carotid artery DCE-MRI at baseline before treatment and at months 3,12 and 24 after rosuvastatin treatment.Their adventitial transfer constant (K) and fractional plasma volume (Vp) were measured and compared during the rosuvastatin treatment.Results The Vp was significantly smaller at months 3,12 and 24 after rosuvastatin treatment than at baseline before rosuvastatin treatment (0.09±0.05,0.07±0.04 and 0.06±0.05 vs 0.12± 0.06,P＜0.05) with a reduction of 25.0％ after 3 months of rosuvastatin treatment and a gradual reduction after 24 months of rosuvastatin treatment (P＜0.05).The adventitial K was mildly reduced after 24 months of rosuvastatin treatment (P＞0.05).Conclusion DCE-MRI can assess the early curative effect of rosuvastatin on carotid atherosclerotic plaques.
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Objective To study the effect of different atorvastatin doses on contrast-induced nephropathy (CIN) and the role of neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of CIN after PCI.Methods Two hundred and twelve patients admitted to our hospital for PCI from June 2015 to January 2017 were divided into high atorvastatin dose treatment group as group A (n=108) and conventional atorvastatin dose treatment group as group B (n=104).They underwent coronary arteriography and PCI.Their serum creatinine and urinary NGAL levels were measured before and at 4,24,48,72 h respectively after coronary arteriography and PCI.The role of urinary NGAL level in early diagnosis of CIN was analyzed according to its ROC curve.Results CIN occurred in 6 patients of group A and in 19 patients of group B with an incidence of 5.6％ and 18.3％ respectively (P=0.012).The urinary NGAL level was significantly higher in two groups at 4,24,48,72 h respectively after coronary arteriography and PCI than before coronary arteriography and PCI,reached its peak at 72 h,and was significantly higher in group B than in group A (P＜0.05).The area under the ROC curve was 0.917,0.919,0.928,0.953 respectively at 4,24,48,72 h after coronary arteriography and PCI.The sensitivity and specificity of urinary NGAL in early diagnosis of CIN were 92.10％ and 100.00％ respectively.Conclusion High atorvastatin dose treatment can reduce the occurrence of CIN.Urinary NGAL level can indicate the change of renal function earlier than serum creatinine level after PCI,and can thus be used as an early predictor of CIN.
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Objective To observe the therapeutic effects and adverse effect of different lipid-lowering regimens in Atherosclerosis renal artery stenosis (ARAS) rat model and select the optimal treatment.Methods 90 Wister rats were randomly divided into sham operation group (group F) and operation group.The operation group was divided into normal feed group (group N) and high-fat feed group (group T).We established the rat model in operatino group by narrowing the renal artery with acupuncture needle and 8 weeks of high-fat feeding.According to the different lipid-lowing therapeutic schedules,the T group rats were randomly divided into five groups:the blank group (T0 group),the Xuezhikang group (T1 group),the rosuvastatin group (T2 group),the regular dose of rosuvastatin combined with Xuezhikang (T3 group),the low dose of rosuvastatin combined with Xuezhikang (T4 group).Mter 6 weeks of intervention,the serum lipids [total cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C)],liver function [alanine aminotransferase (ALT),aspartate aminotransferase (AST)],kidney function [blood urea nitrogen (BUN),serum creatinine (Scr)] and pathological changes of aorta and kidney were detected before and after treatment.Results (1) The blood pressure,BUN and Scr were significantly increased in N group and T group compared with F group (P ＜ 0.05).TC,TG,LDL-C were significantly increased (P ＜ 0.05) and HDL-C were significantly decreased (P ＜ 0.05) in T group compared with N,T group.According to the pathological section,the aorta in T group had visible atherosclerosis change,the renal tubules were atrophied and decreased.All above,the rat model of ARAS was successfully established.(2) After 6 weeks of drug intervention,compared with prior treatment,TC,TG,LDL-C,BUN and Scr were significant decrease (P ＜ 0.05),while HDL-C was significantly increased (P ＜ 0.05) in all treatment groups,and the most remarkable change was in T3,T4 group,T3 group was better than T4 group but with no significant difference between T3 and T4 group (P ＞ 0.05).We found that ALT and AST were significantly increased in T2 and T3 group (P ＜ 0.05) after treatment.Compared with T0 group,pathological lesions of aorta and kidney were reduced best in T3 and T4 group.Conclusions Low dose of rosuvastatin combined with Xuezhikang can achieve ideal lipid-lowing effects.At the same time,it has a protective effect on kidney,and has little damage to liver function.
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Objective To observe the clinical effect and side effect of Xiaozhitang combined with western medicine .Methods Eighty male patients with hyperlipidemia in our hospital was selected from January 2010 to January 2013 and divided randomly into observation group(n=40)and control group(n=40) .Patients in the control group received treatment with atorvastatin calcium (10 mg/d)while patients in the observation group were administrated with Xiaozhitang besides the routine measures .The values of total cholesterol (TC) ,triglyceride(TG) ,high density lipoprotein cholesterol(HDL‐C)and low‐density lipoprotein cholesterol(LDL‐C) serum creatinine(Scr) ,alanine transaminase(ALT) ,aspartate aminotransferase(AST) ,creatine kinase(CK)were assessed before and after 8 ,16 weeks treatment .Drug‐induced adverse effects were also observed .Results TC ,TG ,LDL‐C were (5 .87 ± 0 .89) , (1 .62 ± 0 .62) ,(3 .62 ± 0 .55)mmol/L in the observation group before treatment and significantly reduced after 16 weeks treatment [(4 .59 ± 0 .52) ,(1 .53 ± 0 .53) ,(2 .69 ± 0 .41)mmol/L](P0 .05) .The observation group achieved a significantly greater reduction in LDL‐C and TC than the control group (P<0 .05) .There was a significantly differences in adverse reaction(P<0 .05)but all could be well tolerated .The quality of life score of the observation group was significantly higher than that of the con‐trol group(P<0 .05) .Conclusion The Xiaozhitang combined with atorvastatin calcium could achieve a significantly greater reduc‐tion in lipid‐lowering effect than pure western medicine ,and it shows satisfactory safety and have less side effect .
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Objective To study the effect of atorvastatin pretreatment and ischemia preconditioning on I/R injury in rats .Methods Thirty‐two Wistar rats were randomly divided into sham opera‐tion group ,I/R injury group ,ischemia preconditioning group ,and atorvastatin treatment group (8 in each group) .A reversible focal I/R injury model of rats was established by Longa occlusion of middle cerebral artery .Cerebral tissue samples w ere taken ,cut into 3 μm‐thick sections w hich were stained with HE to observe the morphologic changes in frontal lobe ,parietal lobe and hipp‐ocampal CA1 .Results The karyopyknosis in frontal lobe and cytoplasm acid degeneration in hip‐pocampal CA1 were more significantly in I/R injury group than in sham operation group ,ischemia preconditioning group and atorvastatin treatment group (P<0 .01) .Conclusion ischemia precon‐ditioning and atorvastatin pretreatment can protect rats against I/R injury .
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Objective:To explore the effect between Xuezhikang and rosuvastatin on carotid intima-media thickness (IMT) .Methods :A total of 90 patients with carotid atherosclerosis were randomly and equally divided into control group ,Xuezhikang group and rosuvastatin group according to number table .After six-month treatment ,changes of blood lipid levels and IMT were compared among three groups .Results:Compared with before treatment ,there were significant improvements in blood lipid levels (except high density lipoprotein cholesterol ) and IMT after six months in Xuezhikang group and rosuvastatin group , P 0.05 all) except that LDL-C level of rosuvastatin group was significantly lower than that of Xuezhikang group ( P< 0.05 ) .Conclusion:Both Xuezhikang and rosuvastatin can significantly improve carotid atherosclerosis ,and their therapeutic effects are equal .
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Objective To evaluate the clinical efficacy and safety of short-term intensive statin therapy in patients with acute coronary syndrome ( ACS) .Methods A total of 218 ACS patients admitted in Hangzhou First People′s Hospital from March 2013 to July 2013 were enrolled into this study .The patients were randomly assigned to receive atorvastatin 80 mg/d during hospitalization , and 40 mg/night after discharge for one month ( intensive group , n=107 );or receive atorvastin 20 mg during hospitalization and 20 mg/night after discharge for one month ( control group, n =111 ).The biochemical indexes were measured on the admission and after one-month treatment.Results After one-month treatment, the total cholesterol, triglycerides and LDL cholesterol of intensive group were significantly lower , and the high density lipoprotein cholesterol was higher than baseline values ( 0.75 ±0.14 ) mmol/L vs.( 1.52 ±0.88 ) mmol/L, P<0.05;(2.21 ±0.78)mmol/L vs.(4.55 ±1.12)mmol/L, P<0.05;(1.76 ±0.31)mmol/L vs.(2.23 ±0.77) mmol/L, P<0.05; (1.15 ±0.34) vs.(1.52 ±0.41) mmol/L, P<0.05.The liver enzymes creatine kinase in intensive group was not significantly changed , but the creatinine levels decreased (82.53 ±23.85)μmol/L vs.(57.81 ±15.27) μmol/L, P<0.05, and the blood homocysteine and ultra-sensitivity C-reactive protein levels also decreased compared with the baseline ( 10.52 ±4.66 ) mmol/L vs.(30.70 ±18.82 ) mmol/L, P <0.05;( 8.06 ±2.68 ) mg/L vs.( 19.75 ±11.91 ) mg/L, P <0.05. Conclusions Short-term intensive statin therapy can effectively reduce blood lipid , cholesterol and homocysteine levels and raise HDL cholesterol levels; also with its anti-inflammatory and renal protective effect the therapy can provide more clinical benefit for patients with ACS .
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Objective To investigate the effects,mechanisms,and the optimum doses of Rosuvastatin and Losartan on expression of caveolin-1 in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein(ox-LDL).Methods Human-monocyte cells were separated and changed into the human monocyte-macrophage cells.The model of amerosclerosis was set up.These cells were incubated in different doses of Rosuvastatin(0.1,1.0,5.0 μmol/L) and Losartan (10,50,100 μmol/L),and then cultured in combination of two drags (5.0 μmol/L + 100 μmol/L).Expression of caveolin-1 mRNA was determined with real-time fluorescent quantitative polymerase chain reaction (RT-PCR).Results In ox-LDL group,caveolin-1 mRNA was decreased sharply relative to control group [(0.2533 ±0.00973) vs (0.9410 ±0.03677)] in a concentration-dependent manner (P ＜0.01).Compared to ox-LDL group,expressions of Caveolin-1 mRNA were increased gradually in different doses of Rosuvastatin alone and Losartan alone group [(0.5198 ± 0.04840),(0.6183 ± 0.06740),(0.7257 ± 0.03052) vs (0.2533 ± 0.00973) ; (0.3350 ± 0.04177),(0.4428 ± 0.03804),(0.6049 ± 0.02627) vs (0.2533 ± 0.00973)] in a concentration-dependent manner (P ＜ 0.01) ; the summit expressions of caveolin-1 mRNA were emerged in using Rosuvastatin and Losartan together (F =59.119,P ＜ 0.01).Conclusions Rosuvastatin and Losartan may be responsible for the expression of caveolin-1 in human monocyte-macrophage cells that were induced by ox-LDL.The expressions were up-regulated with dose dependent manner of these drugs,and got the crest stage when using optimum doses of Rosuvastatin and Losartan together.
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Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .
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Objective To observe the clinical efficacy of ezetimibe combined with atorvastatin calcium on hyperlipidemia,and to evaluate the role of ezetimibe on lipid management in elderly patients with coronary heart disease (CHD) after coronary intervention.Methods A total of 150 elderly CHD patients with hyperlipidemia to undergo coronary intervention in our hospital were selected.Patients were randomly divided into the control group and the experimental group (n=75,each).Patients in control group were treated with atorvastatin,and in the experimental group with ezetimibe plus atorvastatin.The change of blood lipids levels and the incidence of adverse reactions were compared between the two groups 1 month after the treatment.Results The numbers of patients with normal serum levels of total cholesterol (TC),triglycerides (TG),low density lipoprotein (LDLC) were much more in the experimental group than in the control group after treatment [68 cases (90.7％) vs.50 cases (66.7％),62 cases (82.7％) vs.44 cases (58.7％),56 cases (74.7％) vs.38 cases (50.7％),x2 =12.87,10.42,9.23,respectively,all P＜0.01].There was no significant difference in the incidence of adverse reactions between the two groups [5.3％ (4 case) vs.2.7％ (2 cases),x2 =0.17,P ＞ 0.05].Conclusions Compared with atorvastatin calcium treatment,ezetimibe combined with atorvastatin calcium treatment has a better clinical efficacy on hyperlipidemia with no increase of adverse reactions in elderly CHD patients.
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Objective To investigate the effect of rosuvastatin on the morphine tolerance in rats and the underlying mechanism.Methods Forty-eight male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 6 groups (n =8 each):control group (group C),morphine tolerance group (group MT),rosuvastatin control group (group RC),rosuvastatin 0.4 mg/kg group (group R1),rosuvastatin 2.0 mg/kg group (group R2)and rosuvastatin 10.0 mg/kg group (group R3).Morphine tolerance was induced by subcutaneous injection of morphine 10.0 mg/kg at 8:00 and 16:00 everyday for 5 consecutive days.The equal volume of normal saline was given in groups C and RC.Normal saline 10 ml/kg was injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups C and MT.Rosuvastatin 10,0.4,2.0 and 10.0 mg/kg were injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups RC,R1,R2 and R3,respectively.The paw withdrawal latency to nociceptive thermal stimulation was measured 1 day before (T1) and 1 day after morphine tolerance was induced (T2).The percentage of maximal possible effect (MPE) was calculated.The rats were sacrificed after the last measurement of pain threshold and the L5 segment of the spinal cord was removed for determination of the expression of extracellular signal-regulated kinase (ERK) and phosphorylated ERK (p-ERK)(by Western blot) and contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) (by ELISA).Results Compared with group C,MPE was significantly decreased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were increased in groups MT and R1 (P ＜ 0.05).Compared with group MT,MPE was significantly increased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were decreased in groups RC,R2 and R3 (P ＜ 0.05).There was no significant difference in the indicators mentioned above between groups R2 and R3,and in the expression of ERK between the six groups (P ＞ 0.05).Conclusion Rosuvastatin can attenuate the morphine tolerance in rats by inhibiting the phosphorylation of ERK and decreasing the level of IL-1β and TNF-α.
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Objective To observe the effect of different doses of atorvastatin in treating elderly acute coronary syndrome.Methods Totally 78 cases with acute coronary syndrome were randomly divided into two groups:low-dose atorvastatin group and high dose atorvastatin group,39 cases for each.The triacylglycerol (TG),total cholesterol(TC),low-density lipoprotein-cholestrol (LDL-C)and high-density lipoprotein-cholestrol (HDL-C) were compared between before and after the treatment.The adverse drug reactions were observed.Results Before treatment,the levels of TG,TC,LDL-C and HDL-C were not statistic significant between the two groups.After treatment of 1 month,3 months,6 months and 12 months,TC and LDL-C of the two groups were decreased than those before treatment,and TC and LDL-C of high-dose atorvastatin group were lower than those of low-dose atorvastatin group,but HDL-C level was not changed compared with before treatment.After treatment of 3 months,6 months and 12 months,TG levels of the two groups were decreased than those before treatment,and TG of high-dose atorvastatin group were reduced than those of low-dose atorvastatin group.The incidence rate of cardiovascular events of high-dose atorvastatin group was significantly lower than those of low-dose atorvastatin group.There was no difference in the incidence rate of adverse drug reactions between the two groups.Conclusions I(s worthy to apply high-dose atorvastatin in clinical treatment for acute coronary syndrome because of its ability to decrease the levels of TG,TC,LDL C,HDL-C and cardiovascular events.
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Objective To observe the effects of grape seed proanthocyanidin extract (GSPE)combined with atorvastatin on carotid atherosclerosis of the elderly. Methods Consecutivly 122 patient aged( 73.2 ±12.8) years with hypercholesterolemia and diagnosed as asymptomatic carotid artery plaques were randomly assigned to single atorvastatin(20 mg/d) treatment group (n=63) and combination treatment (atorvastatin 10 mg/d plus GSPE 400 mg/d) group (n=59).Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and high-sensitive C-reactive protein (hs-CRP) levels were detected before treatment and 3,6,12 months after treatment.Mean maximum carotid intima-media thickness (CIMT),plaque score and stability were also assessed by carotid ultrasound. Results After 3 months of treatment,serum levels of TC,TG and LDL-C in both groups were lower than before treatment (all P＜0.01),but no difference was found between the two groups (P＞0.05).HDL-C levels was enhanced by 20.2％ in combination treatment group after 3 months of treatment (P＜0.05),there was difference after 6 months treatment between two groups (P＜0.05).Serum hs-CRP concentrations were decreased by 1.7 mg/L and 3.6 mg/L,3.8 mg/L and 6.3 mg/L,5.9 mg/L and 8.3 mg/L after 3,6 and 12 months treatment as compared with pretreatment,respectively in the two groups (P＜0.05 or P＜0.01).There was difference in hs-CRP levels between groups after 6 and 1.2months of treatment (P＜0.05 or P＜0.01).There were MMCIMT reduction by 1.3％ and 2.0％ (P＞0.05),3.4％ and 5.3％(P＞0.05 and P＜0.05 ),5.1％ and 8.6％ after 3,6 and 12 months of treatment(P＜0.05 and P＜0.01) in the two groups,with distinct difference after 12 month treatment (P＜ 0.01 ).The plaque scores were declined by 6.8 ％ and 13.1％ ( both P ＞ 0.05 ),14.5 ％ and 28.0％ (P＞0.05 and P＜0.05),19.2％ and 45.0％(P＜0.05 and P＜0.01)after 3,6 and 12 months of treatment while significant difference was found between the two groups after 12 months treatment (P＜0.05).Unstable plaque and the total number of plaque was dropped by 8 and 14 in single group,19 and 28 in combination group,respectively,after 12 months of treatment. Conclusions GSPE combined with atorvastatin may inhibit the development of carotid intima-media thickness,reduce carotid plaque and promote stabilization of carotid plaque.
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Background: Lipid lowering drugs (LLDs) are widely used. However, reports on its adverse cutaneous drug reactions (ACDRs) are scarce. Objectives: The study objective was to review the patterns of LLD induced ACDRs. Methods: We reviewed all LLDs induced ACDRs reported to MADRAC (Malaysian Adverse Drug Reaction Advisory Committee) from January 2005 till December 2009. Results: LLD induced ACDRs (124 patients) comprised of 2.07% of all ACDRs reported during the study period. Statins were responsible for most cases (81.5%), followed by fibrates (15.8%), selective cholesterol-absorption inhibitors (1.4%) and combination therapies (statin/selective cholesterol-absorption inhibitors and selective prostaglandin-2 receptor inhibitor/ niacin) in 1.4%. Majority were due to lovastatin (42.5%), simvastatin (28.1%) and gemfibrozil (8.9%). The three commonest ACDRs reported with statins usage were non-specific dermatitis (45.0%), pruritus/stinging (25.0%) and urticaria/angioedema (10.0%) while fibrates caused non-specific dermatitis (52.2%), urticaria/angioedema (13.0%) and photodermatitis (9.7%). There was no reported case of photodermatitis associated with statin usage. Interestingly, statins were the offending drugs resulting in all the five cases of vesiculobullous eruptions, two cases of Stevens-Johnson syndrome and one case of dermatomyositis. No mortalities were reported to be associated with LLD induced ACDRs. Conclusions: LLD induced ACDRs were not uncommon. Statins were the main putative drugs implicated in those reactions. Spectrum of ACDRs differed between statin and fibrate although non-specific dermatitis remained the main ACDRs in both classes. The unavailability of guided and classified ACDRs reporting accounted for the large number of non-specific dermatitis. Although most LLD induced ACDRs were mild, statins were reported to cause severe ACDRs.
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One hundred patients with chronic renal failure(CRF) undergoing contrast diagnosis and/or interventional therapy were randomly divided into two groups: patients in hydration alone group( n = 49 )received intravenous infusion of 0.9% sodium chloride 12 h before injection of contrast media till 12 h after examination (hydration), patients in atorvastatin plus hydration group (n = 51 ) received atorvastatin 80mg/d 24 h before examintion for 3 d in addition to hydration.The serum creatinine concentrations were measured before and 48 h after injection of contrast media.In atorvastatin plus hydration group, the incidence rate of contrast-induced nephropathy (CIN) was 8% (4/51), which was significantly lower than that of hydration group (24%,12/49 )(P＜0.05).Short-term and large dose administration of atorvastatin plus hydration can decrease the incidence of CIN in patients with chronic renal failure undergoing contrast diagnosis and/or interventional thrapy.
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Objective To describe the impact of stroke clinic on the usage of statins for secondary prevention of ischemic stroke.Methods Data about the demography, social economic status, personal histories, blood lipid profiles, and the status of the usage of statins from 568 serial ischemic stroke patients were retrospectively analysed.Results A total of 51.3% patients followed up in stroke clinic ( 306 patients) and 7.6% patients followed up in general clinic (262 patients) were treated with statins.71.6% patients with and 44.8% patients without hyperlipidemia in stroke clinics were taking statins, which were higher than that patients in the general clinics(27.1% and 2.0% respectively).The patients in the stroke clinics with high LDL-C level ( ＞ 3.4 mmol/L) were more likely to be treated with statins than those with lower level (25.6% vs 14.7%, P = 0.017).Conclusions The rate of statins usage is extremely low in stroke patients followed up in a general clinic, but it can been improved greatly in a stroke clinic.Stroke clinic can narrow the gap between the clinical practice and the guideline for secondary prevention of ischemic stroke.
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Objective To investigate whether intervention with two different dosage of atorvastatin may benefit to plasma level of fibrinogen (Fg) in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were randomly assigned into three groups:the control group (33 cases) treated without lipid-lowering drugs, 10 rag (30 cases) and 20 mg (39 cases) atorvastatin group with 3 days of treatment. Before and after the treatment, the plasma levels of Fg and lipids were detected.Results The treatment of 10 mg atorvastatin did not significantly decrease the level of Fg. Compared to the control group, the level of Fg was markedly reduced by 20 mg atorvastatin (21.6% vs 3.2%,P< 0.05). No changes of lipid levels were observed in any group before and after the treatment, whilst there was no relation between the decreasing percentage of Fg and that of TC(r = 0.125 ,P= 0.618), TG(r = 0.147,P = 0.573) or LDL- C (r = -0.279, P = 0.235 ), HDL-C (r = -0.021, P = 0.157). Conclusion Treatment with high dose atorvastatin (20 mg) for 3 days could reduce the level of Fg, and improve the function of vascular endothehum,which may promote the stabilization of atherosclerotic plaque.