Lai Wen-Ter, Lee Kun-Tai, Chu Chih-Sheng, Voon Wen-Choi, Yen Hsueh-Wei, Tsai Li-Yu, Sheu Sheng-Hsiung
Section of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Shih-Chuang 1st Rd., Kaohsiung 80708, Taiwan.
Int J Cardiol. 2005 Feb 28;98(3):459-64. doi: 10.1016/j.ijcard.2003.11.023.
In addition to lowering lipid profile, statins have pleiotropic effects on improving vascular function. Changes of these pleiotropic effects and their relationship to lipid profile after withdrawal of statin treatment remained unclear.
We investigated the changes of lipid profile and plasma concentrations of human soluble vascular cell adhesion molecule-1 (sVCAM-1) and human tissue type plasminogen activator (tPA) after withdrawal of statin treatment. Twenty-two patients (14 F, 8 M, aged 63+/-13 years) with hypercholesterolemia were treated with atorvastatin (ATOR; 10 mg/day) for 12 weeks. Blood samplings for serum lipid and markers were collected before, after and withdrawal of statin treatment.
The total cholesterol, LDL-cholesterol and sVCAM-1 (from 394.4+/-251.7 to 321.0+/-198.9 ng/ml, p<0.05) all decreased significantly and the tPA (from 9.47+/-3.57 to 11.62+/-3.99 ng/ml, p<0.05) increased significantly after atorvastatin treatment. During the following 3 days after withdrawal of atorvastatin, the total cholesterol and LDL-cholesterol did not show any significant change. However, the plasma sVCAM-1 significantly elevated on day 2 (from 321.0+/-198.9 to 371.2+/-220.4 ng/ml, p<0.05) and the plasma tPA significantly decreased on day 1 (from 11.62+/-3.99 to 10.52+/-3.55 ng/ml, p<0.05) and day 3 (from 11.62+/-3.99 to 10.27+/-3.69 ng/ml, p<0.05). Both the significant elevation of sVCAM-1 and decrease of tPA after withdrawal of atorvastatin treatment occurred within 3 days, while the serum cholesterol and LDL-chol levels did not have any significant change and were still within the therapeutic range.
After 12 weeks of atorvastatin treatment, the beneficial pleiotropic effects can be demonstrated simultaneously with lowering the lipid profile. However, after withdrawal of atorvastatin, the beneficial pleiotropic effects are abrogated rapidly within days and are independent on elevation of serum cholesterol.
除了降低血脂水平外，他汀类药物还具有改善血管功能的多效性作用。他汀类药物治疗停药后这些多效性作用的变化及其与血脂水平的关系仍不清楚。
我们研究了他汀类药物治疗停药后血脂水平以及人可溶性血管细胞黏附分子-1（sVCAM-1）和人组织型纤溶酶原激活剂（tPA）血浆浓度的变化。22例高胆固醇血症患者（14例女性，8例男性，年龄63±13岁）接受阿托伐他汀（ATOR；10mg/天）治疗12周。在他汀类药物治疗前、治疗后及停药后采集血样检测血脂和标志物。
阿托伐他汀治疗后，总胆固醇、低密度脂蛋白胆固醇和sVCAM-1（从394.4±251.7降至321.0±198.9ng/ml，p<0.05）均显著降低，tPA（从9.47±3.57升至11.62±3.99ng/ml，p<0.05）显著升高。在停用阿托伐他汀后的接下来3天内，总胆固醇和低密度脂蛋白胆固醇没有显示出任何显著变化。然而，血浆sVCAM-1在第2天显著升高（从321.0±198.9升至371.2±220.4ng/ml，p<0.05），血浆tPA在第1天（从11.62±3.99降至10.52±3.55ng/ml，p<0.05）和第3天（从11.62±3.99降至10.27±3.69ng/ml，p<0.05）显著降低。停用阿托伐他汀治疗后sVCAM-1的显著升高和tPA的降低均发生在3天内，而血清胆固醇和低密度脂蛋白胆固醇水平没有任何显著变化，仍在治疗范围内。
阿托伐他汀治疗12周后，有益的多效性作用可与降低血脂水平同时显现。然而，但停用阿托伐他汀后，有益的多效性作用在数天内迅速消失，且与血清胆固醇升高无关。
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