目标:他汀类药物,3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂,在控制高胆固醇血症和降低心血管风险方面至关重要。虽然与其他他汀类药物相比,瑞舒伐他汀显示出较好的疗效和耐受性,其在75岁以上急性冠脉综合征(ACS)老年患者中的安全性仍未得到充分探索.所以,本研究的目的是评估75岁以上老年ACS患者的不良反应发生率,并探讨大剂量瑞舒伐他汀对血脂的影响.
方法:在这项观察性研究中,110例连续老年ACS患者在德黑兰的Modarres医院就诊,伊朗,2019年报名。大剂量瑞舒伐他汀在75岁以上老年患者中的疗效通过不良反应比较进行评估。血脂谱,心功能,和其他生物标志物在基线和瑞舒伐他汀治疗6周后,剂量为40mg。
结果:治疗6周后,总胆固醇(136.2±24.3至115.5±24.0,p=0.001)和LDL水平(72.6±17.5至50.9±18.9,p=0.001)显着降低,伴随着HDL水平的显着增加(38.3±7.1至47.2±7.4,p=0.001)。心功能,通过射血分数(EF)测量,从43.4±8.8显著改善到48.5±8.5(p=0.001)。不良反应,如抽筋(N=12,P=0.001),弱点(N=28,p=0.001),报告了厌食症(N=12,p=0.001),但不保证停止治疗.值得注意的是,未观察到黄疸病例。在研究期间,由于主要不良心脏事件(MACE)导致2例死亡。与中风或复发性心肌梗死无关。
结论:完全,大剂量瑞舒伐他汀治疗可有效改善血脂,心功能,和老年ACS患者的肝酶水平,具有可控的不良反应。这些发现强调了瑞舒伐他汀在优化易感人群心血管健康方面的重要性。
OBJECTIVE: Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase, are pivotal in managing hypercholesterolemia and reducing cardiovascular risk. While
rosuvastatin demonstrates superior efficacy and tolerability compared to other statins, its safety profile in elderly patients older than 75 years old with acute coronary syndrome (ACS) remains underexplored. So, the objective of this study is to evaluate the frequency of adverse reactions and investigate the efficacy of high-dose
rosuvastatin on lipid profiles in elderly patients aged over 75 with ACS.
METHODS: In this observational study, 110 consecutive elderly ACS patients attending Modarres Hospital in Tehran, Iran, in 2019 were enrolled. The effects of high-dose
rosuvastatin were assessed in elderly patients older than 75 years old by comparison of the adverse effects, lipid profile, cardiac function, and other biomarkers at the baseline and after 6 weeks of rosuvastatin therapy with a dose of 40 mg.
RESULTS: Following 6 weeks of treatment, there was a significant reduction in total cholesterol (136.2 ± 24.3 to 115.5 ± 24.0, p = 0.001) and LDL levels (72.6 ± 17.5 to 50.9 ± 18.9, p = 0.001), accompanied by a notable increase in HDL levels (38.3 ± 7.1 to 47.2 ± 7.4, p = 0.001). Cardiac function, as measured by ejection fraction (EF), significantly improved from 43.4 ± 8.8 to 48.5 ± 8.5 (p = 0.001). Adverse effects such as cramps (N = 12, p = 0.001), weakness (N = 28, p = 0.001), and anorexia (N = 12, p = 0.001) were reported but did not warrant discontinuation of therapy. Notably, no cases of jaundice were observed. Two deaths occurred due to major adverse cardiac events (MACE) during the study period, unrelated to stroke or recurrent myocardial infarction.
CONCLUSIONS: Totally, high-dose
rosuvastatin therapy effectively improved lipid profiles, cardiac function, and liver enzyme levels in elderly ACS patients, with manageable adverse effects. These findings underscore the importance of
rosuvastatin in optimizing cardiovascular health in this vulnerable population.