Theactual Effects Of10mg Rosuvastatin Compared To20mg At Orvastatin In PCI Patients With Coronary Heart Disease(CHD)

Background:Withtheimprovementoflivingstandardsandanageingpopulation,coronary heart disease has become the first cause of infulcing contemporary humanhealth and death,for the treatment of coronary heart disease,lipid-lowering therapy hasbecome the primary factor,and ststins of lipid-lowering has become cornestone for thetreatment of coronary heart disease.Rosuvastatin and atorvastatin as the most widelyused statins,there are many prospective experiment comparing the lipid-loweringefficacy of rosuvastatin and atorvastatin,many conditions was made in these prospectiveexperiment,but different clinical situation and individual differents, there are less pointto point research in lipid-lowering efficacy of the two drugs.In this paper,a retrospectiveanalysis was made to contrast the lipid-lowering of rosuvastatin and atorvastatin.Objective: To compare the Lipid-lowering efficacy and the safety of10mgRosuvastatin and20mgAtorvastatin in PCI patients with coronary heart disease.Methods: Thisis a retrospective case-control study ina single center.Acohort of307patients with coronary heart disease treated with coronary interventional therapy.Age from18-75(56.17±7.26) years old, including patients with atorvastatin20mg/dayof167cases, and Rosuvastatin10mg/day of140cases. We observed the generalcondition of two groups, and the lipid (TC, TG, HDL-C and LDL-C) levels anddescreased percentage at1st month,3rd month,12th month; Compared thelipid-lowering efficacy and the onset time of the two drugs; Calculated the incidence ofMACE, the incidence of abnormal liver function, the incidence of abnormal renalfunction, the incidence of CK abnormality. At last, a comparison between the groups was measured on the lowing-lipid efficacy and onset time.Results: Rosuvastatin group:After1monthlater,thetotal cholesterol (TC),triglyceride (TG), low density lipoprotein cholesterol (LDL-C) of the group ofRosuvastatin10mg/day were significantly lower than admission, the reducingpercentage are respectively31.2%,16.0%,38.1%, P <0.001. High-density lipoproteincholesterol (HDL-C) was increased compared with the baseline level on admission, thehighest HDL-C amplitude was5.0%, however, there was no significant statisticaldifference (P=0.161). At the3rd month, TC, TG, LDL–C were further reducedcompared with the1st month, the decreasing percentage were36.0%,22.5%,46.1%respectively, there were significant statistical difference (P <0.001). HDL-C levelincreased to6.6%, compared with the level on admission, there was no statisticaldifference (P=0.094); compared with the1st month, there is still no statisticaldifference (P=0.160). After12months, the TC, TG, LDL-C level decreased to37.1%,22.8%,46.9%, compared with the level on admission, there were significant statisticaldifference (P <0.001); compared with the level in3rd month, there were no statisticaldifference (P=0.062, P=0.062, P=0.177respectively). The HDL-C level increasedup to7.6%, there was no statistical difference.Atorvastatin group:After1month later,the total cholesterol (TC), triglyceride(TG), low density lipoprotein cholesterol (LDL-C) of the group of Atorvastatin10mg/day were significantly lower than admission, the reducing percentage arerespectively29.8%,14.1%,33.1%, P <0.001. High-density lipoprotein cholesterol(HDL-C) was increased compared with the baseline level on admission, the highestHDL-C amplitude was5.1%, however, there was no significant statistical difference (P=0.289). At the3rd month, TC, TG, LDL–C were further reduced compared with the1st month, the decreasing percentage were34.7%,20.4%,41.3%respectively, therewere significant statistical difference (P <0.001). HDL-C level increased to6.0%,compared with the level on admission, there was no statistical difference (P=0.129);compared with the1st month, there is still no statistical difference (P=0.713). After12 months, the TC, TG, LDL-C level decreased to35.9%,21.5%,41.8%, compared withthe level on admission, there were significant statistical difference (P <0.001);compared with the level in3rd month, there were no statistical difference (P=0.076, P=0.084, P=0.120respectively). The HDL-C level increased up to7.5%, there was nostatistical difference.10mg Rosuvastatin compared with20mg Atorvastatin, at the1st month, thelevel of TC, TG, LDL–C decreased much significantly, there were statisticallysignificant difference (P <0.05),but there was no significant difference on HDL-Cincreasing (P=0.595). At3rd month, there were still significant statistical differences (P<0.05) between the groups. After12months, the decreasing ratio of TC, TG and LDL–C were as the same as the1st month, there were significant statistically differences (P <0.05) between two groups, there was still no statistical difference in HDL-C elevation (P>0.05). In Rosuvastatin group, there were2cases suffering MACE events, there were5hepatic enzyme abnormalities, there was1Cre increase slightly, there was no CKelevation. In Atorvastatin group, there were3cases suffering MACE events, there were7hepatic enzyme abnormalities, there was1Cre increase slightly, there was no CKelevation; there was no significant statistical differences between the two groups.Conclusion:1.10mg Rosuvastatin has stronger strength trend in lipid-loweringefficacy than20mg atorvastatin; TC, TG and LDL-C can be decreased muchsignificantly by Rosuvastatin, but in increasing HDL-C level ability there was nosignificant difference between them.2. Rosuvastatin and atorvastatin onset in1month,they can achieve maximum lipid-lowering efficacy at3months, and can keep stablethrough the whole therapy till12months.3.10mg Rosuvastatin and20mg atorvastatinare safe and tolerable to patients, there is no necessery to stop or decrement when liverenzymes moderately elevated.