Clinical Observation Of High Dose Of Rosuvastatin In Patients With Large Artery Atherosclerotic Stroke

Background: In recent years,cerebrovascular disease has become the first cause of disability and death of urban and rural residents in China.There are about 2.7 million new patients each year,about 70% of them are ischemic stroke.With the change of the economic level and the way of life,the incidence of large artery atherosclerotic stroke is increasing year by year.LAA stroke is the most common type of cerebral infarction.SeveRe clinical symptoms,poor prognosis and high recurrence rate is the main feature of it.Atherosclerosis(AS)is the most important pathophysiological basis of LAA stroke and one of the key factors lead to the occurrence and recurrence of ischemic stroke.In addition,the inflammatory response can further aggravate the damage of nerve function and worsening the ischemic stroke.Rosuvastatin is a new generation of statins that are effective conventional drugs for the treatment of atherosclerosis and stable plaque.Some studies have shown that rosuvastatin has multi effect neuroprotective effect like multiple effects of anti-inflammatory,stable endothelial cells,antiplatelet aggregation and antioxidation in addition to the effect of lipid regulating.Recent studies have shown that the treatment of high dose of statins is associated with a good prognosis for ischemic stroke.The treatment also reduces the rate of stroke recurrence and mortality.However,there is not much study on the effect of large dose of rosuvastatin on LAA stroke.Objective:To investigate the effect of high dose rosuvastatin on outcomes in patients with large artery atherosclerotic stroke.Thus it can provide new ideas for guiding the acute stage of stroke treatment and implementing effective secondary prevention.Methods:Using a prospective case series study,LAA stroke patients hospitalized in the department of neurology of the affiliated Hefei hospital of Anhui Medical University from December 2015 to April 2017 were continuously collected.They were randomly divided into high dose group and routine dose group.Routine dose group taken 10 mg rosuvastatin calcium daily and high dose group taken 20 mg rosuvastatin calcium daily.After 3 months of treatment,measure the blood lipids and serum inflammatory biomarkers,the incidence of adverse events was compared between groups.The modified Rankin scale(m RS)was used to assess the clinical outcome,a score of 0 to 2 was defined as a good outcome.Results:In this study,100 patients with acute ischemic stroke were included.6 cases were excluded from thrombolytic therapy,3 cases were treated with vascular intervention therapy,and 9 cases were lost to follow-up.Therefore,our study population consisted of 82 patients.47cases were males,35 cases were females.The mean age of the cases was(64.59±12.35)years.According to the random number table method,they were divided into high dose group(39 cases)and routine dose group(43 cases).(1)The proportion of good outcome in the high-dose group was sig-nificantly higher than that of the routine dose group(84.62%VS65.12%,P<0.05).(2)There was no significant difference in mortality,recurrence strok e and hemorrhagic transformation between the two groups(P>0.05).(3)Compared with those before treatment,the levels of high-sensitivi ty C-reactive protein in the routine dose and high dose g-roups were significantly decreased after treatment[(0.56±0.60)mg/L vs(0.70±0.68)mg/L,P=0.01;(0.22±0.29)mg/L vs(0.69±0.58)mg/L,P=0.00].After treatment,compared with the routi-ne dose group,hs-CRP levels in high-dose group were signifi-cantly reduced[(0.22±0.29)mg/L vs(0.56±0.60)mg/L,P=0.00].(4)The proportion of LDL-C<1.8mmol/L,non-HDL-C<2.6mmol/L inth e high dose group was significantly higher(69.23%vs46.51%,P=0.04;66.67%vs41.86%,P=0.03)than that of the routine dosegroup.(5)There were no significant adverse reactions in both groups.Conclusion: High dose of rosuvastatin treatment could significantly increase rate of reaching the standard in blood lipid,lower the level of high sensitivity C-reactive protein and improve the clinical o-utcome of patients with large artery atherosclerotic stroke.