Acute Coronary Syndrome In Patients With Long-term Application Of Statins On Renal Function

Objective:Acute coronary syndrome (ACS) in patients with long-term regular use of statin treatmenton renal function.Methods:Select parallel hospitalized in the Department of Cardiology of our hospital from January2010to December2010310cases of coronary angiography in diagnosis of ACS patients given statin therapy after admission, according to the type of taking statins is divided into: Atorvastatin group (group1,101cases), simvastatin group (group2,93cases), rosuvastatin statin group (group3,60cases), pravastatin group (group4.56cases),according toapplication of the different statin doses (atorvastatin20mg/d) and group2, respectively, in group1and group2is divided into two subgroups:Group1-A(atorvastatin10mg/d),group1-B(atorvastatin20mg/d), group2-A(simvastatin20mg/d), group2-B(simvastatin40mg/d). The rest of the treatment measures (including intervention,anticoagulant, antithrombotic, thrombolysis and coronary heart disease drug treatment)as a routine treatment program. Patients after discharge from their regular follow-up, the average (19.84±4.41) months. Determination of the baseline and follow-up, blood urea nitrogen (BUN), creatinine (CREA,), total cholesterol (TC), triglyceride (TG), low-densitylipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), glutamic acid amino transferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK),and use a formula-the MDRD eGFR value of the selected candidates, comparative analysis of baseline and follow-up (12.23±1.15months) follow-up (21.95±2.56months), changes in renal function and its correlation with other factors. The main index determination:determination of Scr in the picric acid method; determination of blood urea nitrogen(BUN), the enzyme electrode method. Independently with the parameters by the hospital biochemistry laboratory. All data software processing spss13.0statistics.Result:(1) Four groups of patients in age, smoking history, sex ratio, body mass index (BMI),complications during hospitalization and drug therapy are comparable, the difference was not statistically significant;(2) follow-up and follow-up2:①The serum BUN and Scr in the level of eGFR difference was statistically significant (P>0.05) before treatment, but see Scr decreased gradually, eGFR showed a gradually increasing trend;(2) serum TC,TQ LDL-Creduced HDL-C was significantly higher, the difference was statistically significant (P <0.05), but follow-up between a group and follow-up, the TC, TG and LDL-C, HDL-C, no significant difference (P>0.05);③among the three groups comparison of ALT, AST, CK no significant;(3) four groups of patients before and after treatment:the comparison group were followed up for1,2, compared with before treatment, a follow-up group2compared with follow-up and medication before eGFR significantly increased, the difference was statistically significant (P<0.05), there maining three groups before and after treatment compared to Scr eGFR values only see the trend, but without statistical significance (P>0.05); between the two groups follow-up2time points, group1, group2, group3between eGFR values were gradually reduced, and there is a statistically significant (P<0.05), while group4compared with group leGFR decreased (P<0.05), and group3was significantly increased (P<0.05), no significant differences in comparison with group2, before treatment and were followed up for1Scr and eGFR values were no significant differences (P>0.05);(4) group1comparison between the two subgroups in group2; thesame dose group with the extension of the follow-up eGFR values upward trend, but only saw a significant difference (P<0.05) in group two subgroups, the same follow-up time point, with statin dose the greater of eGFR higher the value, but no significant differentcesamong the three groups (P>0.05).(5) age, LDL-C level, mean arterial blood pressure and follow-up2eGFR was negatively correlated; gender, BMI, and follow-up2eGFR (P>0.05).Conclusions:(1)ACS patients with long-term application of statins is effective, safe, with the protection of renal function and slow down in eGFR lower.(2) The ACS in patients with long-term application of different types of statins renal function may exist heterogeneity.(3) In patients with ACS, the stronger statin the longer and the greater the dose, theprotection of renal function.(4) Age, LDL-C levels and blood pressure may affect long-term application of statins in patients with ACS renal function.