Efficacy and safety of different doses of atorvastatin in the treatment of patients with acute coronary syndrome / 中国基层医药

ABSTRACT

Objective To investigate the efficacy and safety of different doses of atorvastatin in the treatment of patients with acute coronary syndromes ( ACS) .Methods 134 ACS patients with cardiogenic shock were randomly divided into two groups .On the basis of treatment of anticoagulation ,reduce myocardial oxygen consumption ,dilation of blood vessels and blood pressure ,the patients were divided into conventional treatment group (group A,67 cases)given atorvastatin calcium treatment 20mg/d;intensive treatment group(group B,67 cases)given atorvastatin calcium treatment 80mg/d,the patients were treated for 12 weeks.The levels of TC,TG,LDL-C and HDL -C in the two groups were observed before and after treatment .The incidence of adverse reactions ,including gastrointestinal discom-fort,myalgia,dermatitis,ALT>3ULN,CK>10ULN in the two groups was observed .The incidence of adverse events such as recurrent angina , heart failure, recurrent myocardial infarction and cardiac death was followed up for 3 months,the difference between the two groups was compared .Results There was no statistically significant differ-ence in serum lipid level between the two groups before treatment (all P>0.05).After treatment,the levels of TC and LDL-C were (3.63 ±1.09) mmol/L,(2.18 ±0.91) mmol/L,which were significantly decreased compared with before treatment [TC (5.52 ±1.23)mmol/L,LDL-C (3.87 ±0.88)mmol/L,t=9.413,10.928,all P<0.01].TG and HDL-C had no statistically significant differences compared with before treatment (P>0.05),and the levels ofTC and LDL-C in group B [(3.15 ±1.13)mmol/L,(1.78 ±0.68)mmol/L] were significantly lower than those in group A [(3.63 ±1.09)mmol/L,(2.18 ±0.91)mmol/L,t=2.502,t=2.882,all P<0.01].Regarding the adverse drug reactions,in group A,gastrointestinal discomfort in 2 cases,3 cases of myalgia,dermatitis in 2 cases,ALT >3ULN in 5 cases,CK>10ULN 0 case.In group B,gastrointestinal discomfort in 3 cases,4 cases of myalgia,dermatitis in 2 cases,ALT>3ULN in 9 cases,CK>10ULN in 0 case.There was no statistically significant difference in the inci-dence rate of adverse reactions between the two groups (P>0.05).The incidence rate of recurrent angina in group B (5.9％) was significantly lower than 17.9％in group A (χ2 =4.542,P<0.05).The number of cases of heart fail-ure in group B was less than that in group A , but there was no statistically significant difference between the two groups (P>0.05).There was no significant difference in the recurrence of myocardial infarction and cardiac death between the two groups (P>0.05).Conclusion Compared with conventional dose of atorvastatin ,ACS patients with enhanced atorvastatin treatment have better control of blood lipids ,less re-cardiovascular events ,adverse drug reac-tions has no significant difference ,but it needs to be further experimental observation and strict monitoring .