To observe the clinical efficacy and safety of different doses of atorvastatin calcium tablets combined with trimetazidine hydrochloride tablets in the treatment of patients with chronic heart failure (CHF).

CHF patients were randomly assigned to low-dose group, high-dose group and control group using a digital randomization method. The control group received conventional heart failure treatment in addition to trimetazidine hydrochloride tablets (20 mg per dose, tid). The low-dose group received conventional atorvastatin calcium tablets (20 mg per dose, qd) on basis of the treatment given to the control group. The high-dose group received higher dose of atorvastatin calcium tablets (40 mg per dose, qd) in addition to the treatment for the control group. All treatment continued for 3 months. The clinical efficacy, heart function indicators, three-dimensional myocardial fibrosis parameters, myocardial cell apoptosis-related factors and safety were compared among the three groups.

A total of 8 cases were dropped during the trial, and 30 cases were included in the low-dose group, 24 cases in the high-dose group, and 26 cases in the control group. After treatment, the efficacy rates were 76.67% (23 cases/30 cases) for the low-dose group, 91.67% (22 cases/24 cases) for the high-dose group, and 61.54% (16 cases/26 cases) for the control group. The difference between the high-dose group and the control group was statistically significant (P<0.05). After treatment, the left ventricular ejection fractions for the low-dose group, high-dose group and control group were (52.25±2.11)%, (55.34±2.76)% and (48.72±2.48)%, respectively; the left ventricular end-diastolic diameters were (51.33±3.94), (48.63±4.79) and (55.79±4.85) mm, respectively; the left ventricular end-systolic diameters were (39.77±3.53), (36.72±3.29) and (42.78±3.69) mm, respectively; troponin Ⅰ levels were (1.62±0.33), (1.36±0.29) and (1.84±0.36) ng·L^-1, respectively; N-terminal pro B-type natriuretic peptide levels were (797.25±79.32), (749.20±84.65) and (854.15±90.57) pg·mL^-1, respectively; global strain values were -29.87±5.19, -32.96±5.82 and -26.33±5.46, respectively; cell membrane receptor protein levels were (2.55±0.46), (2.30±0.36) and (2.84±0.50) μg·L^-1, respectively; soluble Fas ligand levels were (0.23±0.06), (0.19±0.04) and (0.28±0.09) μg·L^-1, respectively; the differences among the three groups and between each pair of groups for the above indicators were statistically significant (P<0.05, P<0.01, P<0.001). The main adverse drug reactions in the low-dose group were gastrointestinal bloating and constipation, while the high-dose group primarily experienced constipation. The control group mainly reported nausea. The incidences of adverse drug reactions in the low-dose, high-dose and control groups were 6.67%, 4.17% and 3.85%, respectively, without statistically significant differences (all P>0.05).

The curative effect of intensive dose atorvastain calcium tablets combined with trimetazidine hydrochloride tablets in the treatment of CHF is better than that of conventional dose atorvastatin combined with trimetazidine hydrochloride tablets, and the safety is good.