Clinical Study Of Combination Lipid Lowering Therapy On The Lipid Lowering Efficacy And Rognosis Of The Patients With Acute Coronary Syndrome

ObjectiveTo evaluate the lipid efficacy and clinical tolerance of patients with acute coronary syndrome who use statins and nicotinic acid drugs,and the effect to acute coronary syndrome prognosis. To provide the evidence for combination of lipid drugs.Materials and MethodsThe objects were hospitalized patients who lived in Cardiac intensive care unit (CCU) of Cardiology department in our hospital from January 2008 to January 2009.160 cases were selected into the combination group and the control group randomly single-blind,each group include 80 patients. Followed up to find out whether adverse events happened or not after (1 month±1 week), (3 months±1 week),or (6 months±1 week),and determined hsCRP,lipids,liver function,renal function,CK,and so on,to find out whether end point events happened during the following 12 months. Two means were compared with t test,and count datas were compared with chi-square test.Results1. After treated,levels of TC,LDL-C in two groups were significantly lower than before (P<0.01),compared with the control group,combined treatment group had significant differences (P<0.05). After treated,levels of TG in two groups were significantly lower than before (P<0.01),compared with the control group,combined treatment group had significant differences (P<0.05).2. HDL-C level was significantly higher than before. Compared with the control group,combined treatment group had Higher HDL-C level (P<0.01).3. HsCRP level after treatment were significantly lower than before (P <0.01),there were significantly difference between two groups (P<0.05).4. In the two groups,1 month later,ALT was abnormal but less than 3 times,and the control group (5.25%) was lower than the combination group (10.5%) (P <0.05), but it could return to normal,3 months later,there was no significant difference (P>0.05). There were 2 cases (2.6%) in the control group,and 2 cases (2.7%) in combination group 3 times more than the normal value, which should be discontinued. There were two cases in each group got renal dysfunction, which could be continued.5 patients in the combination group had flushing and gastrointestinal reaction that could be tolerated. Creatinine.and Ck had no significant difference between the two groups (P>0.05).5. Followed up of the two groups. Cardiac events including cardiac death,acute myocardial infarction,recurrent angina,and vascular reconstruction needed in total incidence of vascular events. During the fllowing 12 month,6 cases (8.0%) in the combination group,while 13 cases (17%) in control group (P <0.05).ConclusionCombination therapy had better clinical tolerance,could elevated lipid lowering efficacy,and improved the prognosis of patients with acute coronary syndrome. This study of patients with acute coronary syndrome provided an important theoretical basis to prevent the occurrence of major cardiovascular events,which combined statins with nicotinic acid drugs.