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Effects of Combined Lipid-Lowering Therapy on Low-Density Lipoprotein Cholesterol Variability and Cardiovascular Adverse Events in Patients with Acute Coronary Syndrome

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Abstract

Introduction

To investigate the effect of combined lipid-lowering therapy on low-density lipoprotein cholesterol (LDL-C) variability and cardiovascular adverse events in patients with acute coronary syndrome (ACS).

Methods

A total of 200 patients with acute coronary syndrome, admitted to the first Hospital of Hebei Medical University from January 2018 to June 2019, were randomly divided into the observation group (100 cases were treated with combined lipid-lowering drugs, including 10 mg/day atorvastatin and 10 mg/day ezetimibe) and the control group (100 cases were given an intensive statin regimen, including 40 mg/day atorvastatin). The levels of blood lipids, creatine kinase (CK), alanine transaminase (ALT), matrix metalloproteinase-9 (MMP-9) and high-sensitivity C-reactive protein (hsCRP) were observed and compared between the two groups. Focus was laid on the concentration of the above-mentioned parameters and follow-up results including the drug safety and incidence of cardiovascular adverse events.

Results

Before treatment, there was no significant difference in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), CK, ALT, MMP-9, hsCRP and LDL-C between the two groups (P > 0.05). After 6 months, 12 months and 24 months of treatment, TC, HDL-C, CK, ALT, MMP-9, hsCRP and LDL-C were improved in both groups, and TC, HDL-C, CK, ALT, MMP-9, hsCRP and LDL-C in the observation group elicited greater results than those in the control group with significant difference (P < 0.05). In the course of treatment, the drug safety of the two groups was compared (P > 0.05), and the incidence of cardiovascular adverse events in the observation group was significantly lower than that in the control group (6.59% vs. 11.96%) (P < 0.05).

Conclusion

Combination therapy with atorvastatin and ezetimibe potentially provides remarkable effects in terms of treating acute coronary syndrome, controlling the variation of LDL-C, alleviating the inflammatory state and reducing the incidence of cardiovascular adverse events with a safe profile. Combined lipid-lowering drugs are considered valid and alternative approaches for wide clinical practice.

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Acknowledgements

We thank the participants of the study.

Funding

This study was supported by 2017 Clinical Medicine Excellent Talents Training Fund from Hebei Provincial Government (No. HBWJ2017BJ50).

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Compliance with Ethics Guidelines

The study was approved by the ethics committee of the First Hospital of Hebei University (no. 20190589). All participants signed informed consent. This study was performed in accordance with the Helsinki Declaration of 1964 and its later amendments.

Disclosures

Huilian Tan, Ling Liu, Qinghou Zheng, Dahong Zhang, Qian Liu, Dong Cui, Lei Gao, Zhen Wang, Wen-Lei Wang and Jun Liu have nothing to disclose.

Authorship Contributions

HTL, LL and JL contributed to the design of the study. QZ, DZ, QL, DC and ZW dealt with patients’ follow-up and contributed to the analysis. QZ, DZ and QL contributed to the interpretation of data. HTL and WW drafted the manuscript. All the authors critically revised the manuscript and gave final approval and agree to be accountable for all aspects of the work, ensuring both its integrity and accuracy.

Data Availability

All data generated or analyzed during this study are included in this published article/as supplementary information files.

Author information

Author notes

  1. Huilian Tan and Ling Liu contributed equally to this paper.

Authors and Affiliations

  1. Department of Cardiology, First Hospital of Hebei Medical University, Shijiazhuang, China

    Huilian Tan, Ling Liu, Qinghou Zheng, Dahong Zhang, Qian Liu, Dong Cui, Lei Gao, Zhen Wang & Jun Liu

  2. Department of Neurosurgery, Emergency General Hospital, Beijing, China

    Wen-Lei Wang

Authors
  1. Huilian Tan
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  2. Ling Liu
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  10. Jun Liu
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Corresponding author

Correspondence to Jun Liu.

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Tan, H., Liu, L., Zheng, Q. et al. Effects of Combined Lipid-Lowering Therapy on Low-Density Lipoprotein Cholesterol Variability and Cardiovascular Adverse Events in Patients with Acute Coronary Syndrome. Adv Ther 38, 3389–3398 (2021). https://doi.org/10.1007/s12325-021-01741-7

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  • DOI: https://doi.org/10.1007/s12325-021-01741-7

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