The Effects Of Short-term Intensive Statin Therapy On Glomerular Filtration Rate In Patients With Acute Coronary Syndrome

BackgroundWith the progress of population aging,CHD(coronary heart disease,CHD)especially acute coronary syndrome(acute coronary syndrome,ACS),has become the main cause of human death.The main pathophysiological mechanisms of ACS are coronary atherosclerotic plaque rupture,thrombosis,platelet aggregation and vasospasm caused consequent formation.According ECG changes in patients with chest pain happening,ACS can be divided into non-ST-elevation ACS and ST-segment elevation myocardial infarction.Where in the former comprises including unstable angina(unstable angina,UA)and non-ST segment elevation myocardial infarction(Non-ST-segment elevation myocardial infarction,NSTEMI).In recent years,with the ACS intervention technology developing and the production of drugs,the mortality and morbidity in patients with ACS was significantly reduced.With the extension of the average life expectancy of the Chinese people,the incidence of ACS is not only rising in the elderly population,but also gradually occurs in younger.In recent years,with the number of coronary heart disease increased year by year,there is more and more attentions on the development of chronic kidney disease in the occurrence of coronary heart disease,the relationship between the two diseases is complex.There is common recognition that Patients with chronic kidney disease have a significant increase in morbidity and mortality rates for coronary heart disease.Studies have shown that patients with mild chronic renal dysfunction,even without coronary risk factors,the incidence of coronary artery disease,Left ventricular hypertrophy,chronic heart failure and stroke also increased significantly.Statins has been widely used to treat patients with CHD,it is a hydroxy-3-methylglutaryl coenzyme A(HMG-Co A)reductase inhibitors,not only suppress the synthesis of cholesterol effect and hypolipidemic,but also anti-inflammatory,anti-oxidative stress,endothelial function improving body.There have research shown that statins through its anti-oxidation,anti-inflammatory,anti-thrombosis,protection of endothelial cells,induced angiotensin receptor down,reduce endothelin synthesis and the independent of lipid-lowering role,to have a protective effect on the kidneys.This study was to compare the effects of short-term intensive dose in patients with ACS standard dose statin therapy in ACS patients statin therapy on renal function,to evaluated the safety and efficacy on renal function with intensive statin therapy.MethodsA total of 200 patients with acute coronary syndromes who were treated at the First People's Hospital of Hangzhou from March 2013 to October 2016 were randomly divided into two groups:the patients treated with atorvastatin(40 mg)with the conventional atorvastatin treatment group(20 mg).Atorvastatin intensive dose group to be 40mg/N during hospitalization and discharged;Atorvastatin standard dose group to be 20mg/N during hospitalization and discharged.Respectively,and before taking the medication the patient to detecting the serum lipids,liver function,high-sensitivity C-reactive protein(hs-crp),creatine kinase(CK),serum creatinine and glomerular filtration rate indicator,while the two groups were recorded number of angina attacks,attack time and serious cardiovascular events,and drug-induced hepatic damage.Results1?Comparison of ACS patients with statin group and conventional statin group:the ratio of male to female in ACS patients was 65/35,82.53 ± 23.85 in serum and 57.81± 15.27 after one month of statin therapy The ratio of male to female was 63/37 in the standard dose of statin group,79.48 ± 19.98 was measured at admission,and 63.99 ± 15.35 after 1 month.Serum creatinine in both groups was lower than that before treatment,the difference was statistically significant(P<0.05).(P<0.05),and the decrease of creatinine value in the intensive group was significantly lower than that in the conventional group(P<0.05).2?Comparison of glomerular filtration rate between the intensive group and the conventional group:the filtration rate of the glomeruli after the treatment group and the conventional group was significantly improved(P<0.05),and the enhancement group(P<0.05),and the improvement of glomerular filtration rate was significantly improved(P<0.05)3?(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipids(LDL-C),high density lipids(LDL-C),and high density lipids Protein(HDL-C)and high-sensitivity C-reactive protein(hsCRP)were improved after treatment(P<0.05).The improvement of the patients in the intensive group was significantly higher than that in the conventional group(P<0.05)4?Compare the safety of intensive group and the standard group:patients were good compliance during the treatment,there were not occurred about the myalgia,liver discomfort,urine traits and number of changes,skin itching and other adverse reactions.Two groups of patients were have patients with mildly elevated transaminases,elevated transaminase in intensive dose group were 3;standard group of elevated transaminase were 2,but did not exceed more than three times the standard value at all.Conclusion Compared with the standard dose of statins group,intensive dose statins group can better improve the patient's renal function,and in the case of more lipid-lowering effect,no significant increase in adverse events.