ABSTRACT
Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.
ABSTRACT
Objective To investigate the effect of statins and angiotensin receptor blocker (ARB) on paroxysmal atrial fibrillation in patients with chronic congestive heart failure. Methods All of 145 patients with chronic congestive heart failure and paroxysmal atrial fibrillation were randomly divided into four groups, Ⅰ group (treated with amiodarone ), Ⅱ group( treated with amiodarone and valsartan), Ⅲ group( treated with amiodarone and pravastatin)and Ⅳ group (treated with amiodarone,valsattan and pravastatin). After 2- year follow-up, observed the changes of left atrium diameter (LAD), C-reactive protein (CRP) and maintenance rate of sinus rhythm before and after treatment. Results After treatment, the data of LAD of the four groups were (44.1 ± 2.1 ), (41.7 ± 2.8), (44.4 ± 3.1 ), (40.1 ± 2.5) mm respectively. The LAD data of beth Ⅰ group and Ⅲ group were significantly higher than those of Ⅱ group and Ⅳ group (P < 0.05), but there was no significant difference either between Ⅰ group and Ⅲ group, or between Ⅱ group and Ⅳ group. The levels of CRP of the four groups were (4.56 ± 0.24), (4.47 ± 0.45 ), (2.87 ± 0.53 ), (2.54 ± 0.42) mg/Lrespectively, and the levels of CRP of Ⅰ group and Ⅱ group were obviously higher than those of Ⅲ group and Ⅳ group(P< 0.05 ), but there was no significant difference either between Ⅰ group and Ⅱ group,or between group and Ⅳ group. Maintenance rate of sinus rhythm of the four groups was 57.9%,79.4%,77.1%,85.3% respectively,the maintenance rate of sinus rhythm of Ⅰ group was significantly lower than that of Ⅱ,Ⅲ and Ⅳ group (P<0.05). Conclusions Va]asrtan and pravastatin may reduce recurrence of paroxysmal atrial fibri]lation in patients with chronic congestive heart failure. Valsartan may inhibit dilatation of left atrium, and pravastatin may decrease the level of CRP in blood.