This paper presents a case of reversible dysphasia occurring in a patient prescribed atorvastatin in combination with indapamide. A milder dysphasia recurred with the prescription of rosuvastatin and was documented on clinical examination. This resolved following cessation of rosuvastatin. The case highlights both a need for a wider understanding of potential drug interactions through the CYP 450 system and for an increased awareness, questioning and reporting of drug side-effects.
Anticholesteremic Agents/adverse effects/*therapeutic use ; Antihypertensive Agents/therapeutic use ; Anxiety/diagnosis ; Aphasia/diagnosis/*etiology ; Cytochrome P-450 Enzyme System/metabolism ; Depression/diagnosis ; Drug Interactions ; Female ; Fluorobenzenes/adverse effects/*therapeutic use ; Heptanoic Acids/adverse effects/*therapeutic use ; Humans ; Hypercholesterolemia/drug therapy ; Indapamide/therapeutic use ; Middle Aged ; Pyrimidines/adverse effects/*therapeutic use ; Pyrroles/adverse effects/*therapeutic use ; Sulfonamides/adverse effects/*therapeutic use

OBJECTIVETo evaluate the efficacy of atorvastatin in preventing contrast agent-induced nephropathy (CIN) in patients undergoing coronary angiography and explore the mechanism.

METHODSA total of 180 patients undergoing coronary angiography or percutaneous coronary interventions (PCI) were randomized into regular dose and high dose atorvastatin groups (n=90). Serum creatinine (Scr), glomerular filtration rate (GFR), cystatin, peripheral blood levels of myeloperoxidase (MPO), malondialdehyde (MDA), and superoxide dismutase (SOD) before and after the procedure were compared between the two groups.

RESULTSThe incidence of CIN was significantly lower in high-dose atorvastatin group than in the regular dose group. At 48-72 h after the surgery, serum Scr and cystatin levels were significantly lower and eGFR was significantly higher in the high-dose group. At 24 h after the surgery, MPO and MDA levels were significantly lower, and SOD activity was significantly higher in high-dose group than in the regular dose group.

CONCLUSIONHigh-dose atorvastatin used before angiography is more effective than the regular dose in attenuating contrast agent-induced renal dysfunction, and its mechanism is related with the inhibition of oxidative stress.

Aged ; Atorvastatin Calcium ; Contrast Media ; adverse effects ; Coronary Angiography ; adverse effects ; Female ; Heptanoic Acids ; administration & dosage ; pharmacology ; therapeutic use ; Humans ; Kidney Diseases ; chemically induced ; prevention & control ; Male ; Middle Aged ; Oxidative Stress ; drug effects ; Pyrroles ; administration & dosage ; pharmacology ; therapeutic use

OBJECTIVESThis study was designed to evaluate the efficacy and safety of rosuvastatin on treating Chinese patients with hypercholesterolemia.

METHODSThis randomized double-blind multi-center study enrolled the patients with LDL-C > or = 160 mg/dL but < 250 mg/dL and TG < 400 mg/dL after six-week dietary run-in. Patients were randomized to receive either rosuvastatin 10 mg/d (R) or atorvastatin (A) 10 mg/d in 2:1 ratio for 12 weeks. Patients with LDL-C levels not reaching goal defined by ATP III guideline in R group were titrated to 20 mg for additional 8 weeks.

RESULTSAltogether, 304 patients were included in the study, 201 patients in R group and 103 in A group. The ITT population is 290 and PP is 263. The LDL-C level decreased after 12 weeks in R group than that in A group, (45.6% vs 39.0%, P < 0.001). The rate reaching the target level defined by ATP III in R group tended to be higher than that in A group (78.0% vs 72.7%), especially in patients with high risk (56.5% vs 35%), however the difference did not reach statistical significance. The magnitudes of TG reduction (-22.8%), HDL-C (+6.6%) and ApoA-1 increase (+12.5%) in R group had no significant difference compared to those in A group (-16.6%, +4.3% and +9.8%, respectively). 29 patients were titrated to receive 20 mg of rosuvastatin. 10 of 22 patients reached the LDL-C target. There were no drug related SAE found during the study.

CONCLUSIONSThe efficacy of rosuvastatin in reducing LDL-C is more effective than atorvastatin in the same dose, however, the safety data is similar between them in the period of 3-month follow-up.

Adolescent ; Adult ; Aged ; Anticholesteremic Agents ; therapeutic use ; Asian Continental Ancestry Group ; Atorvastatin Calcium ; Double-Blind Method ; Female ; Fluorobenzenes ; adverse effects ; therapeutic use ; Heptanoic Acids ; therapeutic use ; Humans ; Hypercholesterolemia ; drug therapy ; Hypolipidemic Agents ; therapeutic use ; Male ; Middle Aged ; Pyrimidines ; adverse effects ; therapeutic use ; Pyrroles ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; adverse effects ; therapeutic use ; Young Adult

To investigate the effect of atorvastatin on reflow in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and its relation to serum uric acid levels.One hundred and fourteen STEMI patients undergoing primary PCI were enrolled and randomly divided into two groups:55 cases received oral atorvastatin 20 mg before PCI (routine dose group) and 59 cases received oral atorvastatin 80 mg before PCI (high dose group). According to the initial serum uric acid level, patients in two groups were further divided into normal uric acid subgroup and hyperuricemia subgroup. The changes of uric acid level and coronary artery blood flow after PCI were observed. Correlations between the decrease of uric acid, the dose of atorvastatin and the blood flow of coronary artery after PCI were analyzed.Serum uric acid levels were decreased after treatment in both groups (all<0.05), and patients with hyperuricemia showed more significant decrease in serum uric acid level (<0.05). Compared with the routine dose group, serum uric acid level in patients with hyperuricemia decreased more significantly in the high dose group (<0.05), but no significant difference was observed between patients with normal serum uric acid levels in two groups (>0.05). Among 114 patients, there were 19 cases without reflow after PCI (16.7%). In the routine dose group, there were 12 patients without reflow, in which 3 had normal uric acid and 9 had high uric acid levels (<0.01). In the high dose group, there were 7 patients without reflow, in which 2 had normal uric acid and 5 had high uric acid (<0.05). Logistic regression analysis showed that hyperuricemia was one of independent risk factors for no-reflow after PCI (=1.01, 95%:1.01-1.11,<0.01). The incidence of no-flow after PCI in the routine dose group was 21.8% (12/55), and that in the high dose group was 11.9% (7/59) (<0.01).High dose atorvastatin can decrease serum uric acid levels and improve reflow after PCI in patients with STEMI.
Acute Disease ; Atorvastatin Calcium ; therapeutic use ; Female ; Heptanoic Acids ; Humans ; Hyperuricemia ; complications ; drug therapy ; Male ; Myocardial Reperfusion ; methods ; Percutaneous Coronary Intervention ; adverse effects ; Pyrroles ; Risk Factors ; ST Elevation Myocardial Infarction ; surgery ; Uric Acid ; blood ; metabolism