The Effect Of Different Doses Of Atorvastatin On Patients With Ischemic Stroke/TIA And Intracranial Atherosclerotic Stenosis

Objective:This study observes the effect of different doses of atorvastatin on low-density lipoprotein cholesterol (LDL-C), ankle-brachial index (ABI), carotid intima-media thickness (IMT) and intracranial atherosclerosis. It also observes the security as well as the incidence of cerebrovascular events of different doses of atorvastatin in order to assess the secondary prevention effect of different doses of atorvastatin on patients with ischemic stroke/TIA and intracranial atherosclerotic stenosis.Methods:Total 150 patients with ischemic stroke/transient ischemic attack (TIA) and atherosclerotic stenosis were enrolled from September, 2008 to April,2010 in the First Affiliated Hospital of Dalian Medical University. All of the patients were divided into three groups randomly-group A, group B and group C, and each included 50 patients. Group A was named intensive therapy group which was given atorvastatin of 20mg every day for 9 months. Group B was named standard therapy group which was given atorvastatin of 10mg every day for 9 months. Group C was named control group which was not given atorvastatin. All patients took medicine to control blood pressure, blood sugar and against the process of platelet aggregation. No other types of cholesterol-lowering drugs were used. All patients accepted treatment and follow-up for 9 months. Observe the changes of low-density lipoprotein cholesterol (LDL-C), ankle-brachial index (ABI), carotid intima-media thickness (IMT) and intracranial artery stenosis before and after the treatment, and also observe the side effects as well as the incidence of cerebrovascular events of different doses of atorvastatin.Results:(1) Comparing to the beginning, the level of LDL-C reduced in group A and group B after treatment for 1,3,6 and 9 months (P<0.05). The level of LDL-C did not change obviously in group A at each period after treatment for 1,3,6 and 9 months (P>0.05). The level of LDL-C did not change obviously in group B at each period after treatment for 1,3,6, and 9 months (P>0.05). Comparing to the beginning, the level of LDL-C did not change obviously in group C after 1,3,6 and 9 months (P>0.05). Comparing to group C, the level of LDL-C in group A and group B reduced after treatment for 1,3,6 and 9 months(P<0.05), and the changes in group A were more obvious than in group B(P<0.05).(2) Comparing to the beginning, ABI increased in group A after treatment for 9 months (P<0.05). Comparing to the beginning, ABI did not change obviously in group B and group C after 9 months (P>0.05). Comparing to group B and group C, ABI in group A increased after treatment for 9 months(P<0.05). ABI in group B and group C were not obviously different after 9 months(P>0.05).(3) Comparing to the beginning, CIMT decreased in group A after treatment for 9 months (P<0.05). Comparing to the beginning, CIMT did not change obviously in group B and group C after 9 months (P>0.05). Comparing to group B and group C, CIMT in group A decreased after treatment for 9 months(P<0.05). CIMT in group B and group C were not obviously different after 9 months(P>0.05).(4) Comparing to the beginning, intracranial artery stenosis did not change obviously in group A, group B and group C after 9 months (P>0.05). Intracranial artery stenosis in group A, group B and group C were not obviously different after 9 months(P>0.05).(5) Comparing to group B and group C, the incidence of cerebrovascular events in group A was lower in the nine months (P>0.05). The incidence of cerebrovascular events in group B and group C were not obviously different in the nine months (P>0.05). No serious side effects were discovered in the three groups.Conclusions: (1) Treatment of atorvastatin with 10mg/d and 20mg/d for 1 month can reduce the level of LDL-C, and the effect of 20mg/d is more obvious. The level of LDL-C can be maintained steadily after treatment of atorvastatin for 1,3,6 and 9 months.(2) Treatment of atorvastatin with 20mg/d for 9 months can increase ABI.(3) Treatment of atorvastatin with 20mg/d for 9 months can reduce CIMT.(4) Treatment of atorvastatin with 10mg/d and 20mg/d for 9 months cannot improve intracranial artery stenosis obviously.(5) Treatment of atorvastatin with 20mg/d can reduce The incidence of cerebrovascular events.