| Backgrounds:The formation and development of atherosclerosis plaque is closely connected with dyslipidemia. Statins, the first-line drugs for the secondary prevention of coronary heart disease, are the most widely used drugs for reducing lipid, and. During the past year, atorvastatin and rosuvastatin were used in our hospital as the main antilipemic drugs. In this research, we mainly analyzed the efficacy and safety of atorvastatin and rosuvastatin, so as to provide guidance for their clinical application.Objective:To analyze the curative effect, adverse reaction, compliance and the influencing factors on the effect of statins.Methods:The patients with coronary heart disease in our hospital using statins for the first time were retrospectively studied. All the patients were administered statins in basic symptomatic treatment, with the basic dosage of atorvastatin and rosuvastatin 20 mg/d and 10 mg/d, respectively. The venous blood of patients at different time points (1d before treatment,1 week,2 weeks,4 weeks,8 weeks and 12 weeks after the first dose) was collected to detect serum lipid levels, including triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). At the same time,3 to 26 months’follow-up was completed to recognize adverse drug effect and patient compliance.Results:There were 127 patients selected in total, in which 33.2% took atorvastatin and 57.0% rosuvastatin. The effects of atorvastatin and rosuvastatin were used for a further case-control research, with the detailed results as follows:① The average duration of atorvastatin and rosuvastatin were almost the same. HDL-C of both groups didn’t changed significantly after treatment, while the TG, TC and LDL-C levels were significantly decreased, which had statistically significance compared with that before treatment (P< 0.05). There was no significant difference between groups in TG, TC or LDL-C levels after 1 week or 2 weeks’treatment (P> 0.05). After 4,8 and 12 weeks’ treatment, the LDL-C levels of the patients in rosuvastatin group were lower than those in the atorvastatin group (P< 0.05). The lipid control rate in atorvastatin group after 4,8 and 12 weeks’treatment was higher than those in atorvastatin group, too (P< 0.05). ② Age, body mass index (BMI), liver function, compliance, and diabetes could affect the lipid control rate for the patients using statins (P< 0.05). Further more, digestive system diseases was one of the important influence factors for rosuvastatin (P< 0.05). It was also proved that age> 70, BMI> 28 kg/m2, poor compliance and diabetes were risk factors of poor lipid control for both atorvastatin and rosuvastatin (OR> 1, P< 0.05). It seems that patients with low liver function were more likely to have high lipid levelsin rosuvastatin group (OR> 1, P< 0.05). ③ There were 9 cases of adverse reactions, with 4 cases (9.1%,4/44) in atorvastatin group and 5 cases (6.0%,5/83) in rosuvastatin group, but we did not find any significant differencebetween groups (P<0.05). There was no significant difference in compliance rate between groups, either (P> 0.05). Age, cultural level, medication knowledge, economic income, payment form and adverse reaction affect patients’ compliance (P< 0.05), and age> 70, knowing little medicine knowledge, self-paying and adverse reactions were risk factors for poor compliance (P< 0.05).Conclusion: ① Small dose of rosuvastatin (10 mg/d) and small dose of atorvastatin (20 mg/d) are both well tolerated, while the lipid management of 10 mg/d rosuvastatin is better than that of 20mg/d atorvastatin, especially in LDL-C. The influence factors of lipid success rate are nearly the same, according to the risk factors for appropriate management is expected to further improve the effectiveness. ② Patients’compliance rate has close relations with both curative effect and adverse reaction. Improvement of drug management for elderly patients, popularizing statin medication knowledge are the necessary measures to improve patient’ compliance rate. |
PDF Full Text Request