Clinical efficacy of statin combined with ezetimibe in the treatment of patients with acute coronary syn-drome after percutaneous coronary intervention / 实用医学杂志

ABSTRACT

Objective To compare the clinical efficacy and safety with statin and ezetimibe in the treat-ment of ACS after PCI. Methods 126 patients with acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI )were divided into three groups according to the lipid-lowering strategy. group Amod-erate-intensity statin group(n = 47),group BEzetimibe combined with moderate-intensity statin(n = 38), group CFortified statin(n = 41). The levels of serum lipids,liver enzymes,creatinine,creatine kinase(CK), and the compliance ratio of lipids were compared between the three groups at 1 month and 6 months after PCI re-spectively. All patients were followed up for 12 months,then reviewing coronary angiography and comparing MACE incidents within 12 months. Results The levels of cholesterol in group A,group B and group C decreased signifi-cantly(P < 0.05)at one month after PCI,the percentage of decrease of TC in three groups was 18.95%,35.61%and 19.84% and 24.89%,and LDL-C was 39.56%,23.99%,respectively. The percentage of TC and LDL-C in group B were significantly lower than those in other two groups(all P < 0.05). One months after PCI,the compli-ance rate of LDL-C in group B(65.8%)was higher than that in A group(34.0%)and C group(31.7%),P <0.05. Six months after PCI,the compliance rate of LDL-C in group B( 91.3% )was still significantly higher than that in group A(79.4%)and group C(84.2%),but P > 0.05. The incidence of MACE in group B was significant-ly lower than that in group A and C(P < 0.05)at 12 months after PCI,while the incidence of side effects in group C was significantly higher than that in group B and group A(P < 0.05). The incidence of neovascular steno-sis in group B was lower than that in group A and C(all P < 0.05). There was no significant difference in the intra-ventricular restenosis among the three groups(all P > 0.05). Conclusions Ezetimibe-statin combination therapy reduced TC and LDL-C levels more significantly than statin alone(including moderate-intensity statin therapy and strengthen statin therapy),and the compliance rate of LDL-C at 1 month after PCI was significantly higher than that of statin alone. The incidence of MACE was lower in combination group than in statin group at 12 months after operation,and the side effects were less. Above all,the combination of statin and ezetimibe may be the secondary prevention for CHD in patients with acute coronary syndrome after PCI.