Study Of The Correlation Between Long-term Use Of Statins And New-onset Diabetes Of Acute Coronary Syndrome Patients

Objective:Long-term regular use of statin therapy and new-onset diabetes of correlation and its possible mechanism of acute coronary syndrome (ACS) combined with non-diabetic patients.Methods:Select concurrent coronary angiography confirmed234cases of acute coronary syndrome (ACS) to merge the non-diabetic patients hospitalized in the Second Hospital of Shanxi Medical University, Department of Cardiology from January2010to December2010, including unstable angina (UAP) patients with138cases, non-ST-segment elevation myocardial infarction (NSTEMI) patients with13cases, ST segment elevation myocardial infarction (STEMI) patients with83cases. Record all patients’ age, gender, height, weight, history of hypertension, family history of diabetes, and various biochemical indicators:fasting plasma glucose (FPG),glycated hemoglobin(HbA1C),insulin resistance index,totalcholesterol(TC), triglyceride (TG),low-densitylipoprotein cholesterol(LDL-C),high-densitylipoprotein cholesterol (HDL-C),glutamic acid aminotransferase enzyme (ALT), aspartate amino transferase (AST), creatinine (CREA), ureanitrogen (BUN), creatine kinase (CK). Divided into four groups based on taking different statins:atorvastatin calcium (group1,94cases,10-20mg/da); simvastatin (group2,79cases,20-40mg/day);rosuvastatin calcium (3,39cases,10mg/day); pravastatin sodium tablets (4,22cases,20mg/day). Among them, the group1, group2were further divided into group1-A,38cases(atorvastatin10mg/day), group1-B,56cases (atorvastatin20mg/day) according to their statin dose;group2-A,57cases (simvastatin20mg/day),group2-B,22cases (simvastatin40mg/day). Outpatient medical records or telephone follow-up clinical and biochemical data of the follow-up period were followed up for14-25months, an average of (19.84±4.41) months. Divided into two groups according to the follow-up time:The average follow-up (12.23±1.15) months (follow-up of1,218cases); the average follow-up (21.95±2.56) months (follow-up of2,183cases).Determination of the main indicators:glycated hemoglobin (HbA1C) by high pressure liquid chamber method; fasting insulin using radioimmunoassay; fasting glucose and other parameters are the biochemical laboratory of the hospital DXC800automatic biochemical analyzer Beckman Coulterinstrument for testing independently. Statistical Methods SPSS13.0statistical package for data analysis, P<0.05was considered statistically significant difference.Results:(1) in patients with ACS before and after treatment:All patients were followed2FPG, HbA1C were significantly increased compared with before treatment, the difference was statistically significant (P<0.05); follow-up2and follow-up1, follow-up1and before administration of FPG, HbA1C comparison only see an increased trend, but no significant difference (P>0.05);183cases were followed up to an average of (21.95±2.56) months, a total of11cases of patients with diabetes, the diabetes incidence rate of4.7%. Follow-up2TC, TG, LDL-C were significantly lower than before treatment,HDL-C was significantly increased,the difference was statistically significant (P<0.05), follow-up of2183cases of blood lipids compliance rate of66.7%; Follow-up2and follow-up1, follow-up1and before treatment TC,TG,LDL-C and HDL-C only a trend but no statistical significance (P>0.05).The IR,ALT,AST,CREA,BUN and CK before and after treatment was no significant difference (P>0.05).(2) before and after taking four different statin drugs:four groups of the patient’s age,sex, BMI,and history of hypertension, family history of diabetes, the IR, TC, TG, HDL-C and LDL-C, CREA, differences were not statisticalsignificance (P>0.05), comparable; four groups within the group of patients, follow-up2FPG, HbA1C significantly higher than before treatment, the difference was statistically significant (P<0.05), follow-up2and follow-up1,follow-up1and medication before of FPG, HbA1C comparison only tended to increase,not statistically significant (P>0.05);between the four groups,before treatment,follow-upl,followed up2at each time point between the groups FPG, HbA1C there was no significant difference(P>0.05).(3) between the different doses of statins (atorvastatin10mg and20mg subgroups and simvastatin20mg and40mg subgroups):at the same dose group, with follow-up time, blood glucose levels gradually increased; at the same follow-up time, with the statin dose increase blood glucose levels gradually increased, but no statistically significant difference (P>0.05) with each other.(4) correlation analysis:age, BMIwith follow-up2FPG positive correlation; gender, LDL-C change in the percentage of, IR with follow-up2FPG no correlation (P>0.05).Conclusion:1. ACS combined with non-diabetic patients with long-term application of small and medium-dose statins to affect glucose metabolism, increasing the trend of new onset diabetes.2.ACS with non-diabetic patients with long-term application of different types of statins increased the degree of risk a class effect of blood glucose levels, with the dose increase and extend the follow-up time, blood glucose and glycosylated hemoglobin levels only to see the increasing trend of increasing, the larger dose group has the higher incidence of onset diabetes.3.Age and body mass index may lead to long-term application of statins in these patients blood glucose levels increased and are important risk factors for trigger new-onset diabetes.4.Long-term application of small doses of statins has good efficacy and safety in ACS combined with non-diabetic patients.