ABSTRACT
BACKGROUND: Studies have shown the combination treatment effectiveness of using rosuvastatin and ezetimibe in patients with chronic coronary artery disease. Our study aim to evaluate the effectiveness of dyslipidemia treatment with the combination of rosuvastatin and ezetimibe 10mg in patients with chronic coronary artery disease compared with 20 mg rosuvastatin. OBJECTIVES: To evaluate the effectiveness of dyslipidemia treatment with the target of LDL-c < 1.4 mmol/L between combination therapy with rosuvastatin 10 mg and ezetimibe 10 mg in patients with chronic coronary artery disease compared with monotherapy increasing the dose of rosuvastatin 20 mg in Vietnam. METHODS: A randomized controlled clinical trial, single-blind, parallel-group with a 1:1 randomized ratio in 103 outpatients with chronic coronary syndromes treated with rosuvastatin 10mg daily. Group A received the combination therapy with rosuvastatin 10 mg plus ezetimibe 10 mg daily, and group B received rosuvastatin 20 mg daily. The primary outcome was to assess the efficacy of low-density lipoprotein - cholesterol (LDL-c) control between rosuvastatin 10 mg plus ezetimibe 10 mg versus rosuvastatin 20 mg after 4 weeks and 8 weeks. RESULTS: After 8 weeks of intervention, the proportion of archived treatment target patients with LDL-c < 1.4 mmol/L in groups A and B was 69.2% and 44.2%, respectively (Risk ratio (RR) = 1.57, p < 0.01), 50% LDL reduction was 27.9% and 55.8%, respectively (RR = 2.00, p < 0.01), and archived both targets were 51.9% and 25.6% (RR = 2.03, p < 0.01). CONCLUSION: Group A's LDL-c reduction effect and target achievement proportion (Rosuvastatin 10mg + Ezetimibe 10 mg) were significantly higher than Group B's (Rosuvastatin 20 mg). Both medication therapies were safe in patients, and the increased dose of monotherapy showed more side effects than the combination therapy.
ABSTRACT
Objectives: To determine the diagnostic performance and influencing factors of 128-slice coronary computed tomography angiography (CCTA) compared with invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD). Methods: A cross-sectional analysis study enrolled 139 patients suspected of having CAD, who underwent and received a 128-slice CCTA and ICA. Results: The patient-based model showed high sensitivity and a positive predictive value of 93.2% and 95.3%, respectively (for stenosis ≥50%). However, these values were lower when analyzed using vessel-based (85.6% and 81.1%) and segment-based (73.9% and 66.6%) models. Specificity and negative predictive value were highest in the segment-based model, decreasing in vessel- and patient-based models at 96.4% and 95.4%, 90.5% and 90.0%, and 36.4% and 42.1%, respectively (for stenosis ≥70%). All diagnostic values were reduced when the calcium score was ≥400 Agatston units. Conclusion: 128-slice CCTA is an optimal, minimally invasive, and high-performance method to diagnose the stenosis and morphology of coronary artery lesions. The diagnostic performance of 128-slice CCTA is very high. Heart rate and body mass index do not affect diagnostic accuracy, whereas a calcium score ≥400 Agatston units is a factor that causes a decrease in diagnostic performance.
