Analysis Of The Efficacy And Safety Of Atorvastatin Combined With Ezetimibe In Patients With LDL-C Above Standard After PCI

Objective:To compare and analyze the lipid-lowering efficacy and safety of medium-dose atorvastatin combined with ezetimibe and high-dose atorvastatin in patients who have been treated with medium-dose atorvastatin after percutaneous coronary intervention?PCI?,but low-density lipoprotein cholesterol?LDL-C?is still above standard.Methods:From October 2018 to November 2019,80 patients,with LDL-C above the threshold??1.8mmol/L?after PCI were enrolled in our hospital,had taken 20mg atorvastatin for more than 4 weeks already.They were randomly divided into two groups:intensive group?atorvastatin 40mg/d?and combined group?atorvastatin20mg/d combined with ezetimibe 10mg/d?.The serum lipids were measured and compared at baseline,4 weeks and 12 weeks,including LDL-C,total cholesterol?TC?,triglyceride?TG?,high-density lipoprotein cholesterol?HDL-C?,non-high-density lipoprotein cholesterol?non-HDL-C?and lipoprotein?a?[Lp?a?].Meanwhile,the indexes of liver function,including alanine aminotransferase?ALT?and aspartate aminotransferase?AST?,and renal function including creatinine?Cr?,and creatine enzyme including creatine kinase?CK?and creatine kinase isoenzyme?CK-MB?were monitored,and the adverse drug reactions during the treatment were recorded.Results:1. After 12 weeks monitoring,LDL-C,TC,TG and non-HDL-C were significantly lower,and HDL-C was significantly higher than baseline?P<0.05?;2. After 4 and 12 weeks monitoring,LDL-C,TC and non-HDL-C in combined group was more significant decrease than those in intensive group(LDL-C:in 4^thweeks 23.2%vs 6.4%,in 12^thweeks 28.2%vs 9.1%,P<0.05;TC:in 4^thweeks 15.0%vs 5.6%,in 12^thweeks 19.2%vs 6.3%,P<0.05;non-HDL-C:in 4th weeks 23.1%vs8.0%,in 12^thweeks 28.6%vs 11.6%,P<0.05);3. After 4 and 12 weeks monitoring,the rate of reaching the standard of LDL-C in combined group was higher than that in the intensive group(<1.80mmol/L,in 4^thweeks 57.6%vs 27.8%,in 12^thweeks 69.7%vs 30.6%,P<0.05;<1.40mmol/L,in4 ^thweeks 18.2%vs 0.0%,in 12^thweeks 21.2%vs 0.0%,P<0.05);4. There was no significant difference in Lp?a?between two schemes before and after treatment?P>0.05?;5. There was no serious side effect of drug intolerance between the two groups, and there was no statistically significant difference in minor adverse drug reactions between the two groups?3 cases in intensive group and 3 cases in combined group??P>0.05?.Conclusion:For patients treated with medium intensity atorvastatin after PCI but still failed to meet the LDL-C standard,medium intensity atorvastatin combined with ezetimibe and fortified atorvastatin could reduce the level of LDL-C further and was safe,and the combined treatment group had a stronger lipid lowering effect.