Short-Term Therapy with High Dose Atorvastatin in Patients with Coronary Artery Disease Can Reduce Inflammatory Process

  • Vida Nesar Hossein Department of Internal Cardiology, Fatemeh Zahra Hospital of Sari, Mazandaran University of Medical Sciences, Mazandaran, Iran.
  • Keivan Yosef Nejad Department of Internal Cardiology, Fatemeh Zahra Hospital of Sari, Mazandaran University of Medical Sciences, Mazandaran, Iran.
  • Fatemeh Abdollahian Department of Internal Cardiology, Fatemeh Zahra Hospital of Sari, Mazandaran University of Medical Sciences, Mazandaran, Iran.
Keywords:
Hydroxymethylglutaryl-CoA reductase inhibitors, C-reactive protein, coronary disease

Abstract

Coronary heart disease is the leading cause of death and disability in adults. The association between acute coronary syndrom (ACS) and elevated serum high sensitivity c-reactive protein (hsCRP) suggests that chronic inflammation of the coronary arterial wall may play an important role. A number of drugs used in the treatment of cardiovascular disease reduce serum CRP. It* is therefore possible that reduced inflammation contributes to the beneficial effects of these medications. This was a double blind randomized clinical trial on 52 patients were admitted because of ACS at the Mazandaran Heart Center, Iran in 2007. The patients were divided to three randomized groups which received 20, 40, 80* mg Atorvastatin daily for 6 months. At the time of study enrollment and 1, 3 and 6 months after initiation hsCRP were measured. 1 and 3 month after 20mg atorvastatin therapy the median serum concentration of hsCRP did not decrease significantly, but at the end of 6th month it was* significant difference. At 40mg dosage from 3th month to 6th month versus 1st month to 3th month it was significant decrease, at the end of 1th month and 3rd month it was not significant. At 80mg dose at the end of 1th month it was not significant but at the* end of 3th month and end of 6th month it was significant. Intensive lipid-lowering therapy with high-dose atorvastatin therapy relative to moderate lipid-lowering therapy with low-dose atorvastatin reduces hsCRP better. We found that treatment with greater dose of atorvastatin might decrease greater in plasma level of hsCRP.

References

Thom TJ, Kannel WB, Silbershatz S, Alexander RW, Schlant RC, Fuster V, et al. Incidence, prevalence and mortality of cardiovascular diseases in the United States. In: Fuster V, O'Rourke RA, Walsh RA, Poole-Wilson P, editors. Hurst's The Heart. 12th ed. New York, NY: McGraw Hill; 2008. p. 3.

Akhvlediani M, Vorobiova E, Emukhvari M, Balavadze M, Vakhtangadze T. C-reactive protein. Atherosclerosis Suppl 2007;8(1):208-9.

Go AS, Iribarren C, Chandra M, Lathon PV, Fortmann SP, Quertermous T, et al. Statin and beta-blocker therapy and the initial presentation of coronary heart disease. Ann Intern Med 2006;144(4):229-38.

Rinfret S, Behlouli H, Eisenberg MJ, Humphries K, Tu JV, Pilote L. Class effects of statins in elderly patients with congestive heart failure: a population-based analysis. Am Heart J 2008;155(2):316-23.

Cannon CP, Steinberg BA, Murphy SA, Mega JL, Braunwald E. Meta-analysis of cardiovascular outcomes trials comparing intensive versus moderate statin therapy. J Am Coll Cardiol 2006;48(3):438-45.

Inoue T, Kato T, Uchida T, Sakuma M, Nakajima A, Shibazaki M, et al. Local release of C-reactive protein from vulnerable plaque or coronary arterial wall injured by stenting. J Am Coll Cardiol 2005;46(2):239-45.

Tziakas DN, Chalikias GK, Stakos DA, Papanas N, Chatzikyriakou SV, Mitrousi K, et al. Effect of statins on collagen type I degradation in patients with coronary artery disease and atrial fibrillation. Am J Cardiol 2008;101(2):199-202.

Boonbaichaiyapruck S, Cheepudomwit S, Panjavenin P, Suthichaiyakul T, Moleelerkpoom W, Benjanuwatra T, et al. Effect of atorvastatin on LDL & hs-CRP in a selected Thai population. J Med Assoc Thai 2008;91(8):1189-95.

Krum H, Ashton E, Reid C, Kalff V, Rogers J, Amarena J, et al. Double-blind, randomized, placebo-controlled study of high-dose HMG CoA reductase inhibitor therapy on ventricular remodeling, pro-inflammatory cytokines and neurohormonal parameters in patients with chronic systolic heart failure. J Card Fail 2007;13(1):1-7.

Mark DB, Knight JD, Cowper PA, Davidson-Ray L, Anstrom KJ. Long-term economic outcomes associated with intensive versus moderate lipid-lowering therapy in coronary artery disease: results from the Treating to New Targets (TNT) Trial. Am Heart J 2008;156(4):698-705.

Akgullu C, Ozdemir B, Yilmaz Y, Kazazoglu AR, Aydinlar A. Effect of intensive statin therapy on arterial elasticity in patients with coronary artery disease. Acta Cardiol 2008;63(4):467-71.

How to Cite
1.
Nesar Hossein V, Yosef Nejad K, Abdollahian F. Short-Term Therapy with High Dose Atorvastatin in Patients with Coronary Artery Disease Can Reduce Inflammatory Process. Acta Med Iran. 48(4):218-221.
Section
Articles