Lipid-modulating Efficacy And Safety Of Rosuvastatin Versus Atorvastatin In Patients With CHD

BackgroundAlong with the population aging and improvement of living standards in our country, the incidence of coronary heart disease has increased year by year. It has become an important problem threatening human survival and life quality. Statins have lipid-lowing, anti-inflammatory, improvement of endothelial function, plaque-stabilizing, anti-atherogenic activities.So the drug not only plays a vital role in primary-and secondary-prevention,but also effectively improve the prognosis of CHD.Rosuvastatin and atorvastatin are two most common drugs of lipid-lowing therapy. Since the different structures and pharmacokinetics,there are differences in efficacy and safety between two drugs. Make sure the efficacy and safety of two drugs towards chinese people further,guiding clinical medication, has become the current hot issues of the academia and clinic.ObjectiveContract the lipid-modulating efficacy and safety of rosuvastatin versus atorvastatin towards coronary heart disease population.Materials and methodsRetrospectvely studied CHD inpatients who is administered with atorvastatin or rosuvastatin for the first time in cardioascular department,Beijing Hospital from June 2013 --December 2013. The drug dosage are:atorvastatin 20mg per day, rosuvastatin lOmg per day. We collected patients’ information about demographic characteristics, family history, risk factors, complications, and laboratory examination.Laboratory examination indexes included blood lipid, fasting glucose, liver and kidney function index and creatase.Using statistical software such as SPSS 19.0 to analyze blood lipid and other serological index before and after 12-month-medications between two group.Analysed the lipid-modulating efficacy and safety between atorvastatin and rosuvastatin in CHD patients and ≥65 year-old CHD patients.ResultsFinally 347 cases were enrolled, rosuvastatin group had 146 cases,while atorvastatin had 201 cases.(1)After 1 year of treatment,the TG, TC, LDL-c levels were significantly decreased(LDL-cRpre vs LDL-cRpos:4.52±0.84mmol/L vs 2.19± 0.31mmol/L,LDL-cApre vs LDL-cApos:4.46±0.89 vs 2.69±0.50mmol/L,P<0.05),while HDL-c was significantly increased(P<0.05).(2)Compared to atorvastatin group,rosuvastatin group had worse decline in LDL-c and TC(Rate of LDL-cR vs Rate of LDL-cA:49.83% vs 37.41%, Rate of TCR vs Rate of TCA:52.22% vs 42.55%, P<0.001) (3)LDL-c<2.59mmol/L as Lipid-lowering criteria, the achieved rate of rosuvastatin group was higher (89.73% vs 46.77%, P<0.001).(4)After 1 year of treatment,he conditions that enzymes abnormally increase (transaminases, total bilirubin,>3ULN or CK>5ULN) didn’t occur, while CK and Creatinine clearance rate change(Ccr)of the two groups was weak(P>0.05).For CHD patients without DM,statin therapy didn’t increase FBG, no patients occurred impaired fasting glucose.(5)The rates of LDL-c,TC change and standardized rate of LDL-c were similar between genders and diffenrent age groups in both rosuvastatin group and atorvastatin group (P> 0.05). (6)After 1 year of treatment,for ≥ 65-year-old patients,the rates of LDL-c,TC change and standardized rate of LDL-c in rosuvastatin group is higher (Rate of LDL-c changeR vs Rate of LDL-c change A: 48.98% vs 36.33%, Standardized rate of LDL-cR vs Standardized rate of LDL-c change A:87.34% vs 39.54%, P<0.05). For ≥65 year old patients,The conditions that enzymes(transaminases, total bilirubin,>3ULN or CK>5ULN) didn’t occur. CCr change of the two groups was weak(P>0.05).For old CHD patients without DM,statin therapy didn’t increase FBG, no patients occurred impaired fasting glucoseConclusion1) Rosuvastatin and atorvastatin both can modulate serum lipid level strongly in patients with CHD, while 10mg rosuvastatin is slightly superior in modulating serum lipid level than 20 mg atorvastatin.2)CHD patients have good tolerance for moderate intensity treatments of rosuvastatin and atorvastatin, there were no side effects about liver,kidney,muscle nor DM.3) The lipid-lowing efficacy of atorvastatin and rosuvastatin is not affected by gender or age.4)Regular dose of statins can modulate serum lipid level strongly in ≥65-year-old CHD patients, and it is well tolerated by the old.