English abstract
Background: Statins are widely prescribed for primary and secondary prevention of cardiovascular events. Rosuvastatin is used extensively nowadays, however its long-term adverse effects on glycemic status, bone and renal function have not fully evaluated as yet. Aim: To determine the efficacy and safety associated with use of rosuvastatin in dyslipidemic patients attending lipid clinic at SQUH over a period of 3 years. Method and Results: The retrospective study analyses electronic medical records of 144 patients from Hospital Information System (Trakcare) on rosuvastatin for treatment of dyslipidemia during the time period from June 1st, 2009 till May 31st, 2012. Changes of laboratory reading were compared to baseline. Rosuvastatin significantly reduced LDL-C, apo B, total cholesterol and TG compared to baseline p<0.05. However, HDL-C was significantly increased at 6 and 12 months compared to baseline while apo A-I was not increased significantly. Fifty one percent of patient achieved LDL-C target of NCEP ATP III. HbAlc was significantly increased in non diabetic patients at 6 and 30 months of rosuvastatin therapy compared to baseline while FBG was increased significantly at 18 and 24 months of therapy in non diabetic patients. Rosuvastatin showed no significant change on ALP, adjusted calcium and serum phosphate levels in medicine that affect bone non-user. Serum urea level was reduced -22% from baseline after 30 months of rosuvastatin therapy p<0.05. Percentage change in serum creatinine level was significantly increased at 24 month (4%) and at 36 months (8%) and significant decline of eGFR were observed at 24 and 36 month (-6.5 and -11 %, respectively). eGFR of non-diabetic patients declined significantly at 24, 30 and 36 months comparing to baseline. Conclusion: Rosuvastatin was effective in reducing LDL-C, apo B, total cholesterol, and TG, however, the effect was not time-dependent, as the reductions after 12, 18, 24, 30 and 36 month were not more than the reduction occurred after 6 months. Moreover, it was not able to increase the HDL-C and apo A-I after one year of therapy. Half of patient achieved LDL C target. Rosuvastatin increased HbAlc in non diabetes and this increment might be more evident in cases of impaired glucose tolerance. This is in line with the recommendation by the FDA warning of possible association of rosuvastatin therapy with increase risk in new - onset of diabetes. Rosuvastatin effect on bone profile, rosuvastatin did not show any positive or negative impact on bone health. Rosuvastatin treated patients showed a significant decline in eGFR after 2 years and 3 years of therapy. The study had some limitations: sample size was small, a retrospective study and patient data incomplete.
