Study on the Efficacy Differences of Moderate-dose Statin Therapy in Patients with Atherosclerotic Cardiovascular Disease among Different Ethnic Groups

Background Statins are the cornerstone of lipid-lowering therapy and moderate-dose statin therapy is the preferred treatment strategy for lipid management in the Chinese population. Despite the widely recognized efficacy of statins in reducing cholesterol levels and preventing cardiovascular diseases, there are significant differences in treatment responses among patients from different ethnic groups. Objective To explore the differences in therapeutic efficacy between Han and Uyghur patients under moderate-dose statin therapy to guide the formulation of individualized treatment plans. Methods A total of 780 patients diagnosed with atherosclerotic cardiovascular disease (ASCVD) by coronary angiography at the First Affiliated Hospital of Xinjiang Medical University's Cardiac Center from 2012 to 2022 were included in the study. Baseline data and laboratory examination results of the patients were collected. Results A total of 780 ASCVD patients were included, with 408 Han and 372 Uyghur patients. The mean age and gender composition of the two groups were statistically significant (P<0.05). Prior to statin therapy, Han patients had higher levels of total bilirubin (Tbil), albumin (ALB), glycated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and proportions of hypertriglyceridemia and hypercholesterolemia compared to Uyghur patients. Conversely, Han patients had lower levels of alanine aminotransferase (ALT), hypoalphalipoproteinemia, hypoapolipoproteinemia A1, and hyperlipoproteinemia a compared to Uyghur patients (P<0.05). After statin therapy, Han patients had higher levels of Tbil, aspartate aminotransferase, ALB, HbA1c, HDL-C, ApoA1, and lower levels of ALT, TC, low-density lipoprotein cholesterol (LDL-C), ApoB, hypoalphalipoproteinemia, hypoapolipoproteinemia A1, and hyperapolipoproteinemia B compared to Uyghur patients (P<0.05). After medium-dose statin therapy, the reduction levels of TC, HDL-C, LDL-C, and ApoB in Han patients were higher than those in Uyghurs (P<0.05) ; the reduction levels of TC, LDL-C, and ApoB were higher in Han patients than those in Uyghurs, and the increase level of HDL-C was lower in Han patients than those in Uyghurs (P<0.05). Patients were categorized into sensitive group (n=124), resistant group (n=104), and Intermediate group (n=552) based on the reduction in LDL-C. The resistant group consisted of 42 Han and 62 Uyghur patients, the sensitive group of 78 Han and 46 Uyghur patients, and the intermediate group of 288 Han and 264 Uyghur patients. The distribution of ethnicities among the three groups was statistically significant (χ2=11.511, P=0.030) . Conclusion Han patients showed a significantly better lipid-lowering effect following moderate-dose statin therapy compared to Uyghur patients. Uyghur patients may require more frequent monitoring of lipid levels and consideration of increased statin dosage or early combination with other lipid-lowering drugs to improve therapeutic efficacy.