The effects of different doses of atorvastatin on serum lipid profile, glycemic control, and liver enzymes in patients with ischemic cerebrovascular accident

BACKGROUND: Despite established effects of atorvastatin on level of serum lipid profile in patients with different underlying clinical conditions, the effects of this drug on other serum biomarkers remain uncertain. We examined the effects of atorvastatin therapy on lipid profile, glycemic control, and liver enzymes in patients with ischemic cerebrovascular accident without any history or clinical evidences of diabetes, heart failure, renal failure, or hepatic disease. METHODS: In a randomized double-blinded controlled trial, ۱۴۰ hospitalized patients with an ischemic cerebrovascular accident were included and randomly assigned to receive either atorvastatin ۴۰ mg (n = ۷۰) or atorvastatin ۲۰ mg daily (n = ۷۰) for ۳ months. The levels of biomarkers were measured at the time of administrating drugs as well as at the time of completing the treatment. RESULTS: A significant reduction was revealed in serum triglyceride, total cholesterol, low-density lipoprotein, non-high-density lipoprotein (HDL) cholesterol, and also aspartate aminotransferase levels as well as a significant increase in serum HDL level following administration of atorvastatin in both case and control groups who received the atorvastatin ۴۰ mg/day and ۲۰ mg/day, respectively (all P < ۰.۰۵۰). Although a significant increase in fasting blood sugar and hemoglobin A۱c was observed in the case group received atorvastatin ۴۰ mg/day (both P < ۰.۰۰۱), but this elevation was not occurred in another group treated with lower dose of the drug (both P > ۰.۰۵۰). CONCLUSION: Daily administration of ۲۰ mg and ۴۰ mg doses of atorvastatin for ۳ months provides improvement in serum lipid profiles; however, because of interfering effect of high-dose atorvastatin on glycemic control status, the use of the former dose may be preferred. This is very important in these patients because the positive effects of high-dose atorvastatin in stroke patients are not confirmed.