Efficacy And Safety Of The Statins For Elderly Patients With Coronary Heart Diseases

Objective:It is really a concern about benefit and risk of long-term taking the statins for the elderly patients(over 80 years old) with coronary heart disease(CHD).Thus, it is irregularly used for this cohort. Besides, it’s a confused question about the appropriate drug choice from the common different statins. This study was designed to explore the effect and difference in lipid-lowering, improvement of the cardiovascular events and major adverse events(AE) among different statins for the elderly patients with CHD.Method:We retrospectively reviewed the clinical data of 300 elderly patients(more than80 years old) diagnosed with CHD during the period of January 2014 and December2015 in the First Hospital of Jilin University. According to the difference in species of stains during observation, the patients were divided into three groups: rosuvastatin group(10 mg/d, n=104), atorvastatin group(20 mg/d, n=94) and pravastatin group(40 mg/d, n=102). Total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol,(HDL-C), low density lipoprotein-cholesterol(LDL-C),alanineaminotransferase(ALT), serum creatinine(Scr), creatine kinase(CK) and other major AEs were collected before treatment and 6 months later, respectively.During the 1 year follow-up period, the occurrence of unstable angina, non-fatal myocardial infarction, and the death caused by cardiovascular disease or the others were recorded.Result:Regarding the level of TC before treatment and 6 months later, the results were(4.60±1.02) mmol/l vs.(3.62±0.93) mmol/l for rosuvastatin group,(4.22±0.94)mmol/l vs.(3.34±0.78) mmol/l for atorvastatin group and(4.29±0.85) mmol/l vs.(3.70±0.76) mmol/l for pravastatin group, respectively(P<0.05). Similarly, regarding the level of LDL-C, the results were(4.60±1.02) mmol/l vs.(3.62±0.93) mmol/l forrosuvastatin group,(4.22±0.94) mmol/l vs.(3.34±0.78) mmol/l for atorvastatin group and(4.29±0.85) mmol/l vs.(3.70±0.76) mmol/l for pravastatin group, respectively(P<0.05). Besides, there was no significant differences were observed in the change rate of TC and LDL-C among the three groups. Considering the eligible criteria of LDL-C level for the guidline recommendation, for rosuvastatin group, atorvastatin group, and pravastatin group, the rate were 61.5%, 58.5% and 42.2% respectively.While, for the TC level, the results were 44.2%, 40.4% and 22.5% respectively. The incidence of major cardiovascular events were 20.2%, 24.5% and 28.4%, with incidence of fatal cardiovascular events 1.0%, 2.1% and 1.0% and all-caused mortality 3.9%,5.3%, and 1.0%, respectively(P > 0.05). No significant difference were founded in ALT, Scr, and CK before and after treatment(P > 0.05). There were no serious AEs, such as impairment of liver, kidney and rhabdomyolysis during the period of observation.Conclusion:For the elderly patients with CHD, all the statins, including rosuvastatin,atorvastatin and pravastatin, could be effective in lipid-lowering, and it’s probably that the rosuvastatin and atorvastatin are better than pravastatin. Within one year of follow-up,there is no significant difference in improving cardiovascular events among them. It’s well tolerated and no obvious AEs were obsevered in all the three statins gro-ups during our observation period.