| Objective:1.To compare the effects of statins reducing the level of LDL-C and non-HDL-C in patients of elderly CHD with T2 DM.2.To analysis the influence of target rate of LDL-C and(or) non-HDL-C on prognosis of the patients of elderly CHD with T2 DM.3.To research the security issues of old age CHD with T2 DM patients using regular dose of statins.Methods:Patients with coronary artery angiography revealed in our hospital between 2010 and2012 were choosen, and according to the inclusion and exclusion standards, then using computer to a random number,and random number divided by 3, the remainder of 0 in Simvastatin group, the remainder was 1of the Atorvastatin group, and the remainder was 2of Rosuvastatin group, and ultimately 244 cases were selected.1.According to the type of statin three groups were divided aming at comparing the effects of different statins in reducing LDL-C and non-HDL-C: A1group: 82 cases used40 mg Simvastatin,B1group: 87 cases used 20 mg Atorvastatin,and C1 group: 75 cases used10mg Rosuvastatin; then followed-up and statisted the number of target rate of LDL-C and non-HDL-C at the time out of hospital for 3 months, 6 months, 12 months, 18 months and24months.2.According to whether the level of LDL-C and(or) non-HDL-C were down to the target four groups were divided: A2 group: 15 cases were both LDL-C and non-HDL-C were not to the target; B2 group: 31 cases were only LDL-C to the target; C2 group: 54 cases were only non-HDL-C to the target; D2 group:80 cases were both LDL-C and non-HDL-C were to the target; and then statisted events of primary end points and the secondary end points to study the influence on prognosis.3.According to the age two groups were divided to study the security of statins in old age patients: A3 group:199 cases with the age berween 60 and 79; B3 group: 45 cases with the age greater than or equal to 80; then statisticed the cases of the following events at the time out of hospital for 3 months, 6 months, 12 months, 18 months and 24 months:asymptomatic increased CK, CK increased with muscle pain, increased AST and ALT, and e GFR decreased.Results:1.The target rate of LDL-C among A1 group, B1 group and C1 group was statistically significant(P<0.05) at the time of out of hospital of 3 and 6 months, and further compassion among the three groups reversed that there was different(P<0.0167) between A1 group and B1 group, A1 group and C1 group. The target rate of non-HDL-C among A1 group, B1 group and C1 group was statistically significant(P<0.05) at the time of out of hospital of 3, 6 months, 12 months, and 18 months, and further compassion among the three groups reversed that there were significant difference(P<0.0167) between A1 group and B1 group, A1 group and C1 group. While the target rate of LDL-C and non-HDL-C was different at the time of out of hospital of 2 years.2.Compared the incidence of primary and secondary end point events in A2, B2, C2 and D2 four groups, and only all-cause mortality was different(P<0.05). And further comparison showed that there was difference(P<0.007) between A2 and B2 group, A2 and C2 group, A2 and D2 group, B2 and D2 group and C2 and D2 group, while there was no different(P<0.007) between B2 and C2 group. Use Logistic regression to analysis the correlation of age, gender and coronary artery lesion counts, kinds of coronary heartdisease, blood pressure and down to the target level of LDL-C and(or) non-HDL-C and prognosis, and it showed that target to the aim of LDL-C, non-HDL-C and both were correlating to all-cause mortality, but age was unchangeable.3.There were no difference(P>0.05) between group A3 and B3 comparing the incidence of asymptomatic increased CK, CK increased with muscle pain,increased AST and ALT, and e GFR decreased.Conclusion:1. Elderly CHD patients with T2 DM could use regular dose of Simvastatin,Atorvastatin or Rosuvastatin to reduce LDL-C and non-HDL-C for a long time; and Atorvastatin and Rosuvastatin are better at the begging(3 to 6 months) of using. While there was no difference between target rate of LDL-C and non-HDL-C with usual dose statins.2. There was limitations to assess the prognosis only with target rate of LDL-C for elderly CHD patients with T2 DM, combining with non-HDL-C might be better.3.For old age CHD patients with T2 DM, long-term using of statins with usual dose was safe. |
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