Effects of different doses of atorvastatin, rosuvastatin, and simvastatin on elderly patients with ST‐elevation acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI)

Abstract

ObjectiveTo conduct a randomized double‐blind prospective study to investigate effect of different doses of atorvastatin, rosuvastatin, and simvastatin on elderly patients with ST‐elevation AMI after PCI.MethodsOne hundred and ninety‐two AMI patients over 60 years old who underwent PCI were randomly divided into six groups: the low atorvastatin group, high atorvastatin group; low rosuvastatin group; high rosuvastatin group; low simvastatin group; high simvastatin group. Demographic data and clinical information as well as coronary angiography parameters were recorded. Plasma levels of CK‐MB, BNP, ALT, and TnI were measured at 12 hr, 24 hr, and 1 week after PCI. Major cardiovascular events (MACE) were recorded and analyzed using Kaplan–Meier (K‐M) curve.ResultsNo significant differences were observed in angiographic and procedural characteristics. In all high dose groups, all levels of CK‐MB, BNP, ALT, and TnI were significantly lower. However, after 1 week of PCI, only CK‐MB, BNP, and TnI showed significant difference between high and low dose groups. Patients in high dose groups had significantly lower rates for surgical or percutaneous intervention, recurrence of angina, and rehospitalization. K–M curve analysis also showed cumulative incidence freedom time of overall MACE in high dose groups was significantly longer. No significant differences were found among different drugs with the same doses.ConclusionPatients with higher doses had lower level of CK‐MB, BNP, ALT, and TnI and lower occurrence of MACE after PCI.

Clinical Nursing Pathway Improves Therapeutic Efficacy and Quality of Life of Elderly Patients with Acute Myocardial Infarction

“…Today, accelerated population aging has driven the constantly rising incidence of AMI and its increasing prevalence at younger ages; moreover, the disease progresses rapidly, which poses a serious impact on patients' physical and mental health and QOL and increases their economic burden [18]. Emergency PCI is the first choice to treat AMI, but due to the decline of patients' body function to varying degrees, it is prone to bring adverse effects on patients' mood and behavior, causing psychological problems such as preoperative anxiety and depression, thus affecting the efficacy of clinical treatment and nursing [19][20][21]. Routine nursing only focused on saving patients' lives, but ignored the changes of patients' emotional and psychological state, which affected patients' QOL [22,23].…”

Associated factors for discontinuation of statin use one year after discharge in patients with acute coronary syndrome in China

“…However, two studies with relatively small sample sizes in Chinese showed that no significant differences of MACE and declined renal function between atorvastatin and other statins. 35 36 On the other hand, a large observational study in the USA found that 10 mg or 20 mg of atorvastatin use had lower cardiovascular (CV) event rates particularly in the first year of use than 20 mg or 40 mg of simvastatin 37 while another large observational study in the UK found that the risk of hepatotoxicity (small numbers of events observed) was increased in the first 6 months of atorvastatin compared with simvastatin treatment. 38 It might also be a reflection of the strong marketing activities that led to a better confidence in the brand among both doctors and patients, but we have no evidence to support this hypothesis and also it is beyond the scope of the current report.…”

“…We hypothesise that the good adherence to atorvastatin might be due to the better tolerability, and its efficacy and safety. However, two studies with relatively small sample sizes in Chinese showed that no significant differences of MACE and declined renal function between atorvastatin and other statins 35 36. On the other hand, a large observational study in the USA found that 10 mg or 20 mg of atorvastatin use had lower cardiovascular (CV) event rates particularly in the first year of use than 20 mg or 40 mg of simvastatin37 while another large observational study in the UK found that the risk of hepatotoxicity (small numbers of events observed) was increased in the first 6 months of atorvastatin compared with simvastatin treatment 38.…”

Enhanced-Dose Statins for ST-Segment Elevation Myocardial Infarction Patients after Emergency Percutaneous Coronary Intervention

“…This may be because atorvastatin has a unique chemical structure, namely, aromatic groups, which form hydroxyl-activated metabolites that prolong the half-life of atorvastatin to improve vascular endothelial function, reduce cholesterol, and inhibit platelet aggregation, oxidation, and inflammation. They also increase other cardiovascular protective functions and regulate lipids, which can be further improved by enhanced-dose application [ 21 , 22 ]. For example, an enhanced atorvastatin dose reduces platelet aggregation and activation.…”