The efficacy and long-term impact of different doses of statins in patients with acute coronary syndrome.

Abstract

We aimed to evaluate the clinical efficacy of different doses of atorvastatin in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI). In this prospective, randomized controlled study, we enrolled 147 patients with ACS who underwent PCI at our hospital between April 2020 and June 2021. Participants were randomly assigned to three groups based on their post-PCI atorvastatin dose: low-dose (20 mg/day, n=49), medium-dose (40 mg/day, n=49), and high-dose (80 mg/day, n=49). We assessed clinical parameters including blood lipid profiles, inflammatory marker levels, creatine kinase (CK) levels and liver and kidney function before and after atorvastatin treatment. Adverse reactions were monitored to evaluate the safety and efficacy of the different atorvastatin doses. The mean follow-up duration was 13.76±1.27 months (range 12-15 months). No significant differences in baseline blood lipid levels, CK levels and inflammatory markers were observed among the groups (all P>0.05). Post-treatment, the high-dose atorvastatin group showed a more pronounced reduction in blood lipid levels and higher CK levels compared to the medium-dose and low-dose groups. Similarly, the medium-dose group had better outcomes than the low-dose group, with these differences being statistically significant (P<0.05). The high-dose group also exhibited significantly lower levels of inflammatory markers than both the medium-dose and low-dose groups after treatment (P<0.05). Adverse reactions were relatively infrequent across all groups: 4.08% in the low-dose group (1 case of nausea, 1 case of insomnia), 8.16% in the medium-dose group (1 case of insomnia, 1 case of dyspnea, 1 case of nausea, and 1 case of muscular soreness ), and 16.33% in the high-dose group (2 cases of nausea, 1 case of dyspnea, 2 cases of insomnia, and 3 cases of muscular soreness). There was no statistically significant difference in the incidence of adverse reactions among the groups (χ²=4.421, P=0.110). To sum up the results, high-dose atorvastatin significantly improved blood lipid profiles and reduced inflammatory markers in ACS patients following PCI, without adversely affecting liver or kidney function. Furthermore, the high-dose regimen demonstrated a favorable safety profile, suggesting its potential benefit in managing these patients population.