Abstract
Aim: to assess the efficacy and safety of combined lipid-lowering therapy including statin and ezetimibe in patients with acute coronary syndrome (ACS) who are followed up in a short-term study. Patients and Methods: a prospective cohort study involved 50 patients who were divided into 2 groups (25 patients in each group) by sequential inclusion. In group 1, atorvastatin (80 mg) plus ezetimibe (10 mg) were prescribed. In group 2, pitavastatin (4 mg) plus ezetimibe (10 mg) were prescribed. Over a 6-month follow-up period, changes in the clinical signs and parameters of carbohydrate and lipid metabolism were evaluated. Results: at baseline, total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and glucose levels were similar in the groups. After 1 month, LDL-C <1.4 mmol/L were reported in less than 50%. Meanwhile, a decrease in LDL-C <1.4 mmol/L or a decrease in LDL-C by ≥50% occurred in 17 (68%) patients in each group. After 6 months, glucose levels in group 1 were significantly higher than those in group 2 (p=0.034). Intragroup analysis of blood glucose changes over time revealed a significant increase after 6 months in group 1 (p=0.005) but no significant changes in group 2. Over a 6-month follow-up period, diabetes was newly diagnosed in four patients, with no significant differences between the groups. Conclusion: a comparable clinical lipid-lowering efficacy of both treatment regimens was demonstrated. Significantly higher blood glucose levels were reported in the atorvastatin group than in the pitavastatin group, with no significant differences between the groups in newly diagnosed carbohydrate metabolism disorders. The most significant limitation of this study was the small sample size and relatively short follow-up period. KEYWORDS: diabetes, acute coronary syndrome, atorvastatin, pitavastatin, ezetimibe, lipid metabolism, carbohydrate metabolism. FOR CITATION: Druk I.V., Korennova O.Yu., Yukhina Yu.E., Savchenko M.V., Podol'naya S.P., Shukil L.V. Comparative assessment of combined lipid-lowering therapy in patients with very high cardiovascular risk. Russian Medical Inquiry. 2023;7(9):572–579 (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-3.
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