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How Low can We Go with Three Intermediate Dose Statins in Very High Risk Patients ?
영남대학병원 순환기 내과
김웅, 박종선, 이원재, 이상희, 홍그루, 신동구, 김영조, 심봉섭
Background and Objectives : Recent clinical trials have demonstrated additional cardiovascular risk reduction with high-dose statin therapy in western pateints with coronary heart disease (CHD). The recommended drug doses are often lower in Asian poputlation than in Western people. The aim of this study is to evaluate whether different kinds of statins can affect in lipid lowering ability and intermediate dose statin in Asians can have same power to lower cholesterol shown in Western patients. Materials and Methods : Total 122 patients (Male=81) who visited Yeungnam University Hospital and diagnosed as CHD and dyslipidemia were enrolled. Patients were randomely divided into 3 groups and treated with three different statins with intermediate potency; Group 1 (n=35) was defined as those who took simvastatin/ezetimibe 10/20 mg, Group 2 (n=41) was defined as those who took atorvastatin 40 mg and Group 3 (n=46) was defined as those who took rosuvastatin 10mg. Total cholesterol (T-CHO), low density lipoprotein cholesterol (LDL-C), aspartate transferase (AST), alanine transferase (ALT) and c-reactive protein (CRP) were measured on admission and at 8 month after mediation and analyzed among groups. Results : Baseline characteristics among groups including age, sex, diabetes, hypertension, T-CHO, LDL-C(136.7±29 mg/dL in Group 1, 142.2±28 mg/d L in Group 2, 149.5±32 mg/dL in Group 3, p=0.182) and CRP levels were not statistically different. At 8 month after discharge, LDL-C lowering ability was similar among groups (76.2±22 mg/dL in Group 1 vs 73.8±27 mg/d L in Group 2 vs 78.8±25 mg/dL in Group 3, p=0.659). The frequency of LDL-C lowering than 100 mg/dL (85.7% in Group 1, 90.2% in Group 2, 87% in Group 3, p=0.82) and those of LDL-C lowering than 70 mg/dL (60% in Group 1, 73.2% in Group 2, 60.9% in Group 3, p=0.382) among groups were also similar. AST, ALT and CRP levels were not statistically different. Conclusions : Intermediate dose statin have a powerful lipid lowering effect regardless of kinds. Like the results of high dose statin therapy in Western, Intermediate dose statin in Asians may have a similar results.


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