The study of safety and efficacy of two different doses simvastatin in patients of acute coronary syndrome in early stage

Objective To investigate the safety and efficacy of two different doses simvastatin in patients of acute coronary syndrome(ACS) in early stage. Methods 153 consecutive patients with ACS were divided into two groups randomly: group 1 ( n =77) was given 40 mg /d simvastatin at night, group 2 (n=76) was given 20 mg /d simvastatin. The efficacy of simvastatin therapy, the cardiovascular events or incidence of stroke and drug adverse reaction were recorded in 6 month follow up. Results Compared to those before treatment, the total plasma cholesterol, triglyceride, low density lipoprotein, aplipoprotein B, heightening high desisity lipoprotein and Apolipoprotein A decreased significantly at 6 week and 6 month after treatment in both groups( P 0 05). There was significant difference in the two groups after treatment ( P 0 05). According to China Heart Association Suggestion: Abnormal of blood lipid in prevention and treatment, Group 1 was better than group 2 in reaching to target blood lipid goal level on total cholesterol and lower density lipoprotein( P 0 05). Comparing with group 2 there were relatively lower recurrent angina pectoris, congestive heart failure and arrhythmia occurrence in group 1 during hospitalization ( P 0 05). There were significantly lower recurrent angina pectoris, congestive heart failure ,non fatal myocardial infarction , recanalization therapy with percutaneous transluminal coronary angioplasty (PTCA) or with coronary artery bypass surgery(CABG) and re hospitalization in group 1 during the 6 month follow up ( P 0 05). There were significantly different in serum plasmnogen activator inhibiter 1, fibrinogen, C creatin protein and plasma D dimer in the two groups after 6 weeks treatment ( P 0 01). The drug adverse reaction was mild and similar in two groups. Conclusions The use of 40 mg/d simvastatin seems safety and efficacy in heightening target blood lipid goal rate, inhibiting inflammation factor, declining cardiovascular events and incidence of stroke in patients with ACS in early stage. The early use of simvastatin 40 mg/d will be good in safety, efficacy and tolerance.