| BackgroundArteriosclerosis is the process which blood lipids and complex carbohydratesdeposited in damaged artery intima,accompanied by inflammatory cytokines such asleukocytes,monocytes and macrophages. Dyslipidemia plays a very important role inthe progress of atheriosclerosis.Decreased the levels of blood lipids,especiallylow-density lipoprotein cholesterol(LDL-C),is essential in the process ofarteriosclerosis.Currently statins are lipid-lowering drugs recognized widely inclinical.Recently,a series of studies demonstrated.potent lipid-lowering therapy (LLT) can delay or even reverse the progression ofcoronary plaque.This conclusion makes us pay more attention to the selection oflipid-lowering drugs. But for some people, a simple treatment of statins is ineffective.We will observe the effects of the combination of ezetimibe and rosuvastatin onblood-lipids and coronary plaques in patients suffering coronary heart disease(CHD)by coronary angiongraphy(CAG).The study may do some new explorations to thechoosing of lipid-lowering drugs in clinical.ObjectiveTo observe the different effects of rosuvastatin and ezetimibe combined with routine rosuvastatin on blood-lipids and coronary plaques in patients of CHD byCAG.MethodsA total of105patients,elected from September2012to December2012atDepartment of Cardiology in the First Affiliated Hospital of ZhengzhouUniversity,with at least one major coronary artery’s diameter stenosis50~70%byCAG were studied and randomly assigned to a10mg rosuvastatin group(n=35),a20mg rosuvastatin group(n=35) and a combined treatment group (ezetimibe10mg,rosuvastatin10mg,n=35).They were treated for12months.The changes ofblood-lipids and the degree of coronary artery stenosis were compared and after12-months treatment.Results1. Security: During the study, one patient in20mg rosuvastatin group wasterminated treatment because alanine transaminase (ALT) increased to254mmol/L.After12months of lipid-lowering therapy,among the three groups, the difference ofALT, aspartate transaminase (AST)、creatine kinase (CK) and creatinine (Cr) was notsignificant (P>0.05).2.Lipid levels: After12months of lipid-lowering therapy, compared with thebaseline,the drop ratio of LDL-C in the control group is（27.7±10.2）%(P=0.02)；the drop ratio in20mg rosuvastatin group is (41.0±11.7)%(P=0.007)；the drop ratioin combined treatment group is (47.1±10.7)%(P=0.02).Among the three groups thedifference in rate of decline was significant (t=4.12，P=0.009).3. Hs-CRP levels: After12months of lipid-lowering therapy, the level ofhs-CRP in the control group decreased from (3.49±0.72) mg/dl to (1.23±0.86) mg/dl(P=0.04), the level of hs-CRP in20mg/d rosuvastatin group decreased from (3.18±0.63) mg/dl to(0.29±0.93) mg/dl (P=0.01), the level of hs-CRP in combined treatmentgroup decreased from(3.03±0.58) mg/dl to(0.65±1.02) mg/dl (P=0.008). Among the three groups the difference in rate of decline was significant (t=3.12，P=0.04).4.Coronary angiography: After12months of lipid-lowering therapy, the dropratio from baseline of stenosis in control group is (1.09±10.50)%;the drop ratio in20mg rosuvastatin group is (10.70±10.85)%decrease from baseline; the drop ratioin combined treatment group is (18.48±11.93)%.The difference of decline rate ofstenosis among the three groups was significant (t=2.14，P=0.03), and combinedtreatment group is the most. The decline rate of stenosis is positively correlated withthe level of LDL-C (r=0.568, P=0.01).ConclusionCompared with rosuvastatin(20mg/d),ezetimibe(10mg/d) and rosuvastatin(10mg/d) combined treatment significantly decrease serum lipid level and coronaryplaques area, which are associated with reducing the LDL-C level, in patients of CHD.Rosuvastatin(10mg/d) can not stop the progress of coronary plaque. |
PDF Full Text Request