Sadeghi Roxana, Asadpour-Piranfar Mohammad, Asadollahi Marjan, Taherkhani Maryam, Baseri Fariba
Associate Professor, Cardiovascular Research Center, Department of Interventional Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Associate Professor, Department of Interventional Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
ARYA Atheroscler. 2014 Nov;10(6):298-304.
Despite established effects of atorvastatin on level of serum lipid profile in patients with different underlying clinical conditions, the effects of this drug on other serum biomarkers remain uncertain. We examined the effects of atorvastatin therapy on lipid profile, glycemic control, and liver enzymes in patients with ischemic cerebrovascular accident without any history or clinical evidences of diabetes, heart failure, renal failure, or hepatic disease.
In a randomized double-blinded controlled trial, 140 hospitalized patients with an ischemic cerebrovascular accident were included and randomly assigned to receive either atorvastatin 40 mg (n = 70) or atorvastatin 20 mg daily (n = 70) for 3 months. The levels of biomarkers were measured at the time of administrating drugs as well as at the time of completing the treatment.
A significant reduction was revealed in serum triglyceride, total cholesterol, low-density lipoprotein, non-high-density lipoprotein (HDL) cholesterol, and also aspartate aminotransferase levels as well as a significant increase in serum HDL level following administration of atorvastatin in both case and control groups who received the atorvastatin 40 mg/day and 20 mg/day, respectively (all P < 0.050). Although a significant increase in fasting blood sugar and hemoglobin A1c was observed in the case group received atorvastatin 40 mg/day (both P < 0.001), but this elevation was not occurred in another group treated with lower dose of the drug (both P > 0.050).
Daily administration of 20 mg and 40 mg doses of atorvastatin for 3 months provides improvement in serum lipid profiles; however, because of interfering effect of high-dose atorvastatin on glycemic control status, the use of the former dose may be preferred. This is very important in these patients because the positive effects of high-dose atorvastatin in stroke patients are not confirmed.
尽管阿托伐他汀对不同潜在临床病症患者的血脂水平有既定影响,但该药物对其他血清生物标志物的影响仍不确定。我们研究了阿托伐他汀治疗对无糖尿病、心力衰竭、肾衰竭或肝病病史及临床证据的缺血性脑血管意外患者的血脂谱、血糖控制和肝酶的影响。
在一项随机双盲对照试验中,纳入140例住院的缺血性脑血管意外患者,并随机分配接受阿托伐他汀40毫克(n = 70)或每日阿托伐他汀20毫克(n = 70)治疗3个月。在给药时以及治疗结束时测量生物标志物水平。
在分别接受阿托伐他汀40毫克/天和20毫克/天的病例组和对照组中,给药后血清甘油三酯、总胆固醇、低密度脂蛋白、非高密度脂蛋白(HDL)胆固醇以及天冬氨酸转氨酶水平均显著降低,血清HDL水平显著升高(所有P < 0.050)。虽然在接受阿托伐他汀40毫克/天的病例组中观察到空腹血糖和糖化血红蛋白A1c显著升高(均P < 0.001),但在接受较低剂量药物治疗的另一组中未出现这种升高(均P > 0.050)。
每日服用20毫克和40毫克剂量的阿托伐他汀3个月可改善血脂谱;然而,由于高剂量阿托伐他汀对血糖控制状态的干扰作用,可能更倾向于使用前一种剂量。这在这些患者中非常重要,因为高剂量阿托伐他汀对中风患者的积极作用尚未得到证实。