Effects of Evolocumab Combined with Atorvastatin on Elderly Patients with Coronary Heart Disease
Objective To investigate the effects of evolocumab combined with atorvastatin on vascular endothelial function and the levels of serum soluble CD40 ligand(sCD40L),lipoprotein related phospholipase A2(Lp-PLA2)and Apelin in elderly patients with coronary heart disease(CHD).Methods A total of 204 elderly patients with CHD who received treatment at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to September 2022 were divided into the group A and the group B by random number table method,102 cases in each group.The group A was given routine treatment and Atorvastatin calcium tablets,and the group B was given evolocumab injection on the basis of the group A.Both groups continued treatment for 6 months.The clinical efficacy after 6 months of treatment,including vascular endothelial function,the levels of serum sCD40L,Lp-PLA2,Apelin,blood lipid indicators and cardiac function parameters before and after 6 months of treatment,the safety during the treatment period were compared of two groups.Results The rate of total effective in the group B after 6 months of treatment was 93.14％,which was higher than 78.43％in the group A(P＜0.05).Compared with before treatment,after 6 months of treatment,the levels of serum endothelin-1(ET-1),sCD40L,Lp-PLA2,Apelin,low-density lipoprotein cholesterol(LDL-C)and lipoprotein a[Lp(a)]in both groups decreased,and compared with the group A,the group B was lower.The levels of serum nitric oxide(NO),vascular endothelial growth factor(VEGF),flow mediated vasodilation(FMD),left ventricular ejection fraction(LVEF),and cardiac index(CI)in the two groups increased,and compared with the group A,the group B was higher(P＜0.05).The incidence of adverse reactions in the group B during the treatment period was lower than the group A(P＜0.05).Conclusion Evolocumab could significantly regulate blood lipid indicators in elderly patients with CHD,improve cardiac and vascular endothelial function,regulate the levels of serum sCD40L,Lp-PLA2,Apelin,and thereby improve clinical efficacy,with high safety.
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