Effects Of Statins Reduction On The Lipid Of Patients With Ischemic Stroke After Achieved LDL-C Goal

[Background] Statins is a secondary prevention based medicine of Ischemic stroke, Nowadays, there are many treatment guidelines and expert consensus on the target of lipid-lowering proposal, but there is little research on how to continue using statins after achieved LDL-C goal, thus the aim of this study is to study the effect of statins reduction on lipid of ischemic stroke patients.[Objective] To observe the effect of statins reduction on blood lipid levels of patients with ischemic stroke, who reach the normal standard of blood lipid after the use of statins.[Methods] Patients who are diagnosed with acute ischemic stroke from December 2015 to December 2016 in the First Affiliated Hospital of Chongqing Medical University, then we began to test when the LDL-C decreased to 1.8mmol/L or the LDL-C reduce ≥ 50% after 20 mg atorvastatin treatment or 10 mg rosuvastatin treatment. The dose of atorvastatin and rosuvastatin was reduced to half for 50% of the patients,which means that those patients were ramdomly categorized into atorvastatin routine group, atorvastatin reduction group, rosuvastatin routine group and rosuvastatin reduction group. After a month, we examined the lipid. Observing the levels of TG, HDL-C and LDL-C, andfollowing-up with muasthenia, myalgia, impaired liver function, etc.[Results] A total of 115 patients were included in the trial, there were15 cases out of the test, so the actual observation were 100 cases. There were 29 patients in atorvastatin routine group, 25 patients in atorvastatin reduction group, 26 patients in rosuvastatin routine group, and 20 patients in rosuvastatin reduction group. Compared the difference bwtween routine group and reduction group in age, sex, history of hypertension, diabetes,coronary heart disease and the baseline lipid(TG, HDL-C, LDL-C), there were no statistica difference(P>0.05). After 1-month treatment, the LDL-C was increased in the atorvastatin routine group with 2 people(6.9%), 4people(16%)in the atorvastatin reduction group; 2 people in the rosuvastatin routine group(7.7%), and 3 people in the rosuvastatin reduction group(15%). It found that TG and LDL-C levels were decreased in both atorvastatin and rosuvastatin routine group(P=0.012、P<0.001), and both reduction groups could decrease LDL-C level(P<0.001). Compared with atorvastatin reduction group, atorvastatin routine group could reduce the level of LDL-C & TG(P=0.004, P=0.003), and increase the level of HDL-C more effectively(P=0.016); as for rosuvastatin routine group, it could decrease the level of TG more effectively than rosuvastatin reduction group, and there was no statistical difference between the two groups in reducing the level of LDL-C and increasing the level of HDL-C(P=0.591,P=0.603). However, there was a significant difference on LDL-C reduction rate between the two routine groups and reduction groups after one month treatment(P=0.001). Three cases of patients with elevated ALT were found in the trial, not more than 3 times of the normal value.[Conclusions] Low-dose atorvastatin and rosuvastatin can reduce LDL-C level. Its effect is weaker than moderate-dose, and that a few ofpatients’ LDL-C level rebound after treatment, but it is in a smaller range,thus we can try to reduce the dose of statins on ischemic stroke patients after achieved LDL-C goal.