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大剂量阿托伐他汀与瑞舒伐他汀对急性冠状动脉综合征患者血脂参数、氧化型低密度脂蛋白及枯草溶菌素9型前蛋白转化酶的比较作用

Comparative effects of high-dose atorvastatin versus rosuvastatin on lipid parameters, oxidized low-density lipoprotein, and proprotein convertase subtilisin kexin 9 in acute coronary syndrome.

作者信息

Altunkeser Bulent B, Tuncez Abdullah, Ozturk Bahadir, Tezcan Huseyin, Ates Muhammet S, Yilmaz Canan, Yalcin Muhammed U, Aygul Nazif, Demir Kenan

机构信息

Departments of Cardiology.

Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey.

出版信息

Coron Artery Dis. 2019 Jun;30(4):285-290. doi: 10.1097/MCA.0000000000000715.

DOI:10.1097/MCA.0000000000000715
PMID:30741744
Abstract

AIM

Current guidelines recommend administration of high-dose statins in acute coronary syndrome (ACS). It has been reported that statins upregulate proprotein convertase subtilisin kexin 9 (PCSK9) mRNA expression and increase circulating PCSK9 levels. We aimed to compare the effects of high-dose atorvastatin and rosuvastatin on serum oxidized low-density lipoprotein (oxidized-LDL) and PCSK9 levels in statin-naive patients with ACS.

PATIENTS AND METHODS

One hundred and six patients with ACS were enrolled in this study. The patients were assigned randomly to receive atorvastatin (80 mg/day) or rosuvastatin (40 mg/day) by using a ratio of 1 : 1 in randomization. The levels of total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol, LDL-cholesterol, oxidized-LDL, and PCSK9 were compared between groups after a 4-week treatment.

RESULTS

Our study population included 53 patients in the atorvastatin group (age: 58.13±11.30 years, 11.32% female) and 53 patients in the rosuvastatin group (age: 59.08±12.44 years, 15.09% female). In both groups, lipid parameters, oxidized-LDL, and PCSK9 values changed significantly according to the baseline following treatment. High-dose atorvastatin and rosuvastatin induced similar decreases in LDL-cholesterol, oxidized-LDL, and triglyceride levels and similarly increased in high-density lipoprotein cholesterol and PCSK9 levels (P>0.05).

CONCLUSION

We showed that atorvastatin and rosuvastatin treatment regimens have comparable effects on lipid parameters and PCSK9 levels in ACS patients.

摘要

目的

当前指南推荐在急性冠状动脉综合征(ACS)中使用大剂量他汀类药物。据报道,他汀类药物可上调前蛋白转化酶枯草溶菌素9(PCSK9)mRNA表达并增加循环PCSK9水平。我们旨在比较大剂量阿托伐他汀和瑞舒伐他汀对初治ACS患者血清氧化型低密度脂蛋白(氧化型LDL)和PCSK9水平的影响。

患者与方法

106例ACS患者纳入本研究。采用1∶1的比例随机将患者分配接受阿托伐他汀(80mg/天)或瑞舒伐他汀(40mg/天)治疗。治疗4周后比较两组患者的总胆固醇(TC)、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、氧化型LDL和PCSK9水平。

结果

我们的研究人群包括阿托伐他汀组53例患者(年龄:58.13±11.30岁,女性占11.32%)和瑞舒伐他汀组53例患者(年龄:59.08±12.44岁,女性占15.09%)。两组中,治疗后血脂参数、氧化型LDL和PCSK9值均较基线有显著变化。大剂量阿托伐他汀和瑞舒伐他汀使低密度脂蛋白胆固醇、氧化型LDL和甘油三酯水平降低程度相似,高密度脂蛋白胆固醇和PCSK9水平升高程度相似(P>0.05)。

结论

我们表明,阿托伐他汀和瑞舒伐他汀治疗方案对ACS患者的血脂参数和PCSK9水平具有相似的影响。

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