Efficacy and safety of different doses of atorvastatin in ACS patients with PCI preoperative

Objective To study the efficacy and safety of different doses of atorvastatin on lowering intensive lipid in acute coronary syndrome(ACS) patients with percutaneous coronary intervention(PCI) during the preoperative period. Methods A randomized control study was used:100 patients with ACS were selected randomly divided into two groups. 20 mg group,50 patients were given doses of atorvastatin 20 mg/d. 40 mg group,50 patients were given doses of atorvastatin 40 mg/d. Treatment time lasted for 1 month from before PCI to after PCI. cTnI of the blood samples were detected at the day before PCI,24 h after PCI,5 days(D) and 30 days(D) after PCI. Results(1) cTnI of two groups increased 24 h after PCI(P 0.01) ,and the cTnI of the 20 mg group increased more obviously than that of the 40 mg group(P 0.05) .(2) After treatment,LDL-C and TC of two groups at 5D and 30D after atorvastatin treatment were significantly lower than those before treatment(P 0.01) . At each time point after treatment,LDL-C and TC decreased more significantly in 40 mg group than in 20 mg group,the difference was statistically significant(P 0.05) . Atorvastatin for one month,the compliance rate of LDL-C(LDL-C ≤ 1.8 mmol/L) in 40 mg group was higher than 20 mg group(24% vs 66%,P 0.01) .(3) Comparing with the 20 mg group,major cardiovascular events including repeated ischemic anginal attack requiring hospitalization,again myocardial infarction,heart failure,cardiac death in 40 mg group was significantly lower(P 0.05) .(4) There is no significant difference in side effects between two groups(P 0.05) . Conclusions Atorvastatin 40 mg used in ACS patients with preoperative PCI significantly reduced LDL-C,TC,cTnI level,and improved LDL-C success rate,reduced preoperative major cardiovascular events.