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Assessing the effect of high-dose rosuvastatin in elderly patients over 75 with acute coronary syndrome
Maryam Taherkhani1, Zeinab Khanifar2, Adineh Taherkhani3
1Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
High-dose rosuvastatin effectively improved lipid profiles and cardiac function in elderly patients with acute coronary syndrome (ACS). Adverse effects were manageable, supporting its use in this vulnerable population.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Statins are crucial for managing hypercholesterolemia and reducing cardiovascular risk.
- Rosuvastatin is known for its efficacy and tolerability, but its safety in elderly ACS patients (>75 years) is less understood.
Purpose of the Study:
- To evaluate adverse reactions of high-dose rosuvastatin in elderly ACS patients (>75 years).
- To assess the efficacy of high-dose rosuvastatin on lipid profiles and cardiac function in this population.
Main Methods:
- An observational study involving 110 elderly ACS patients (>75 years).
- Patients received high-dose rosuvastatin (40 mg) for 6 weeks.
- Evaluated lipid profiles, cardiac function (ejection fraction), and adverse effects at baseline and after treatment.
Main Results:
- Significant reductions in total cholesterol and LDL, with an increase in HDL observed.
- Ejection fraction significantly improved post-treatment.
- Common adverse effects included cramps, weakness, and anorexia, which were manageable and did not lead to discontinuation. No jaundice was reported. Two deaths from MACE occurred, unrelated to stroke or MI.
Conclusions:
- High-dose rosuvastatin effectively improved lipid profiles and cardiac function in elderly ACS patients.
- Adverse effects were generally manageable, indicating rosuvastatin's potential role in optimizing cardiovascular health in this demographic.
Backgrounds And 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.
Conclusion:
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.
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