The lipid regulating effects of 40 mg per day of atorvastatin on ACS patients after PCI

Objective To investigate the lipid lowering effect of 40 mg/d compared with 10 mg/d of atorvastatin as well as the incidence of adverse reactions and clinical events of different drug dosage in patients with acute coronary artery syndromes (ACS) after PCI. Methods A total of 92 CAG confirmed ACS patients who underwent PCI were randomly divided into two groups and were prescribed with atorvastatin 10 mg/d (group A, n=46) or atorvastatin 40 mg/d (group B, n=46) after PCI therapy. Data was collected ater 1, 4, 12 and 24 weeks of atorvastatin therapy. Results A 6.5% and 8.6% of patients were missed during follow up in group A and group B respectively. (1) The peak level of ALT was recorded at week 1-4 in both groups. The rate of ALT elevation in group A was less than group B (20.9% vs 45.2%) after 1 week (P0.05). There were 2 cases in group A and 3 cases in group B showed an elevation of ALT level 3 folds higher than the normal reference value and required discontinuation of atorvastatin treatment. All the patients recovered after the drug stopped. Two patients developed abnormal renal function in both group A and group B. (2) In group A and group B, the TC lowering rate was 12.3% vs 21.7% (P=0.042) after 12 week and became 11.1% vs 23.4% (P=0.005) after 24 weeks respectively. The LDL lowering rate was 10.0% vs 29.5% (P=0.000) after 24 weeks. The percentage of LDL≤1.80 mmol/L after 24 weeks was 19.5% vs 51.2%, P=0.005) in group A and group B. (3) No statistically significant difference was found in the incidence of recurrent cardiac events between the two groups. Conclusion (1) The intensive dosage of atorvastatin 40 mg/d may be safe in the Chinese populations. (2) Atorvastatin 40 mg/d can significantly increase the rate of reaching the lipoprotein regulation goal, especially for LDL≤1.8 mmol/L on ACS patients after PCI.