Keleş Telat, Akar Bayram Nihal, Kayhan Tuğba, Canbay Alper, Sahin Deniz, Durmaz Tahir, Ozdemir Ozcan, Aydoğdu Sinan, Diker Erdem
Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey.
Anadolu Kardiyol Derg. 2008 Dec;8(6):407-12.
In this study, we aimed at comparing the effects of standard once daily 20 mg atorvastatin treatment with that of atorvastatin 20 mg administered every other day on serum lipids and high sensitive C-reactive protein (hs-CRP) levels.
Sixty-one patients with serum total cholesterol levels of above 200 mg/dl and low density lipoprotein (LDL)--cholesterol levels of above 130 mg/dl were included in this prospective, randomized study. The patients were randomized into daily treatment of 20 mg atorvastatin (standard treatment) and 20 mg atorvastatin every other day (every other day treatment) groups. Before the treatment and at each visit, serum lipids and hs-CRP levels of all the patients were measured. Statistical analyses were performed Chi-square, unpaired t and two-way repeated measurements ANOVA tests.
In the every other day treatment group, there was a 36.1% reduction in LDL-cholesterol levels by the end of first month (p<0.01). At the end of three months there was further decrease of 10.2% in LDL-cholesterol levels when compared to 1 month levels (p>0.05). The LDL cholesterol levels of the group receiving 20 mg atorvastatin every day was reduced by %41 by the end of 1 month (p<0.01). At the end of three months, the difference between the changes in the all lipid parameters of the two groups was not found to be of statistical significance. In the group receiving the medication every other day, there was a 21% decrease in hs-CRP levels compared to the basal measurements at the end of first month (p<0.05). In the group, receiving the medication every day the decrease in hs-CRP levels at the end of one month was more striking (37%, p<0.05). However, the effects of both treatment arms on hs-CRP levels, did not differ significantly (p>0.05).
Alternate-day dosing of atorvastatin causes a significant lipid-lowering and antiinflammatory effects similar to that of daily administration and yet may provide some cost savings.
在本研究中，我们旨在比较标准的每日一次20毫克阿托伐他汀治疗与隔日服用20毫克阿托伐他汀对血脂和高敏C反应蛋白（hs-CRP）水平的影响。
本前瞻性随机研究纳入了61例血清总胆固醇水平高于200毫克/分升且低密度脂蛋白（LDL）胆固醇水平高于130毫克/分升的患者。患者被随机分为每日服用20毫克阿托伐他汀（标准治疗）组和隔日服用20毫克阿托伐他汀（隔日治疗）组。在治疗前及每次就诊时，测量所有患者的血脂和hs-CRP水平。进行卡方检验、非配对t检验和双向重复测量方差分析。
在隔日治疗组中，第一个月末LDL胆固醇水平降低了36.1%（p<0.01）。与1个月时的水平相比，3个月末LDL胆固醇水平进一步下降了10.2%（p>0.05）。每日服用20毫克阿托伐他汀组在1个月末LDL胆固醇水平降低了41%（p<0.01）。3个月末，两组所有血脂参数变化的差异无统计学意义。在隔日服药组中，第一个月末hs-CRP水平较基础测量值下降了21%（p<0.05）。在每日服药组中，1个月末hs-CRP水平下降更为显著（降低37%，p<0.05）。然而，两种治疗方法对hs-CRP水平的影响差异无统计学意义（p>0.05）。
阿托伐他汀隔日给药可产生与每日给药相似的显著降脂和抗炎作用，且可能节省一些费用。
