Early And Extensive Use Of Statins In Patients With Acute Coronary Syndrome

Objective:This study aimed to investigate the efficacy in patients with acute coronary syndrome using high-dose statins during the period of hospitalization as well as to observe the security.Methods:A total of 67 selected patients are enrolled In this study. Patients are randomly divided into high-dose atorvastatin(n=41) and low-dose atorvastatin(n=26). We choose 5-day for the period of observation in this study. We give atorvastatin-20mg per night for maintenance therapy in low-dose atorvastatin group. We give atorvastatin-80mg per night for maintenance therapy for 5-say and 20mg per night from the 6th day in high-dose atorvastatin. Conventional therapy is given according to the patients situation and low-salt low-fat diet is given. UA,CRP and Fbg are measured at baseline and at 24 hours and after 5-day. Lipid, liver function and renal function are measured at the 2nd day and the 6th day.Results:1. The two groups are similar with UA, CRP and Fbg at the time of procedural. The decline of UA, CRP are significantly more in two groups at 24-hours(P<0.001): but Fbg has no decline. The decline of UA: 7.0% VS 10.4%(P=0.060), CRP:32.2% VS 42.5%(P=0.012), UA and CRP are both lower than at 24-hour in two groups(P<0.001), the decline of UA :10.9 % VS 14.9%(P=0.259), CRP:76.3% VS 84.9%(P=0.035), Fbg is higher than at 24-hour in two groups, but has no significantly in two groups 37.7% VS 38.4%(P=0.700). 2. At 5-day clinical follow-up, 3.8% of the cases occured MACE in placebo and 0% in atotvastatin group(3.8% VS 0%, P=0.016), the other adverse events(9.6% VS 1.8%, P=0.004). TC, TG and HDL have no significant change, LDL decline in two groups, but has no difference between groups.3. 8 patients have a increase in ALT after 5-day in low-dose atotvastatin group and 21 in high-dose atotvastatin group(31% VS 51% ,P=0.059), no patient quit the research because ALT increase >3times. Both groups have a increase in BUN and Crs(BUN 46% VS 66%, P=0.057, Crs 58% VS 77%, P=0.055), all <1 time.No one gets myopathy in two groups.Conclution:1. Early use of high-dose atorvastatin in ACS can reduce uric acid and c-reactive protein. Fbg has a ascent with the period of treatment.2. Taking high-dose of atorvastatin in patients with ACS during hospitalization reduce the occurrence of MACE better than taking low-dose, and has nothing to do with lipid-lowing effect.3. The use of high dose atorvastatin does not reduce drug use safety.