P169High dose statines reduce carotid artery intima-media thickness (IMT) and decrease the risk for general cardiovascular disease

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Abstract

Purpose

To use High dose Statins in non symptomatic patients with increased Carotid Intima-Media Thickness (IMT) to reduce the incidence of Cardiac Arrhythmias and of fatal or non-fatal Coronary Artery Disease (CAD) among patients at increased risk for cardiovascular disease

Methods

We investigated 170 patients who had increased ITM 1.1-1.4mm, had low-density lipoprotein (LDL) cholesterol levels of 100 to 190 mg per deciliter (2.6 to 4.9 mmol per liter), and had not known Cardiac Arrhythmias and CAD. The patients were divided in two groups. One group (69 patient) was treated with 80 mg Simvastatin per day and second group (101patient) with 20mg simvastatin per day. ACI and Aspirin 100mg were prescribed to both groups

Results

The mean LDL cholesterol level during the trial was 73 mg per deciliter (1.9 mmol per liter) among patients receiving simvastatin 80mg per day and 117 mg per deciliter (2.9 mmol per liter) among patients receiving 20mg simvastatin per day. IMT in patient receiving 80mg simvastatin preserved or diminished 0.1-0.89mm, and in patients receiving 20mg simvastatin preserved or increased after 1,9 years. During a median follow-up of 1,9 year, 15 patients (21,7 %) receiving simvastatin 80mg per day and 30 patients (29,75%) receiving 20mg had a fatal or nonfatal CAD and atrial and ventricular arrhythmias.

Results

The group received 80mg simvastatin had 3 atrial fibrilacion,1 ventrikular arrhytmias;7 NONSTEMI and 4 STEMI, whereas the group, received 20mg simvastatine had 8 atrial fibrilacion and other atrial arrhythmias,3 ventricular arrhythmias;12 NONSTEMI and 7 STEMI.

Results

4 (5,7%) patients from 80mg simvastatine group and 9 (8,9%) from 20mg simvastatin group died from cardiac and cardio-cerebral event.

Results

The five-year absolute reduction in the risk of major cardiovascular events was 3.5 percent.

Results

The overall mortality rate was low in patient received high dose simvastatin.

Results

IMT also that is one of them marker of cardiovascular disease, did not changed or improved. Elevated liver enzyme values were more common in patients taking simvastatin in high dose

Conclusions

In patients with increased Carotid IMT and increased risk for cardiovascular disease and without known cardiac arrhythmias and coronary heart disease, 80 mg of simvastatin per day reduced the overall incidence of Cardiac Aarrhythmias and ACS and of other cardiovascular events, and improves Carotid IMT values as a marker of general cardiovascular disease.

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