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阿托伐他汀早期治疗对血脂正常的不稳定型心绞痛患者血栓形成过程的影响。

Effects of early administration of atorvastatin treatment on thrombotic process in normocholesterolemic patients with unstable angina.

作者信息

Tousoulis Dimitris, Bosinakou Erini, Kotsopoulou Maria, Antoniades Charalambos, Katsi Vasiliki, Stefanadis Christodoulos

机构信息

Cardiology Unit, Hippokration Hospital, Athens University Medical School, 69 S. Karagiorga, 16675, Glifada, Athens, Greece.

出版信息

Int J Cardiol. 2006 Jan 26;106(3):333-7. doi: 10.1016/j.ijcard.2005.02.011.

Abstract

BACKGROUND

Although statin-treatment during the acute phase of unstable coronary syndromes improve the outcome their effects on thrombosis/fibrinolysis system in normocholesterolemic patients admitted with unstable angina remain obscure. We assessed the effects of short-term atorvastatin treatment on thrombotic/fibrinolysis markers in normocholesterolemic in patients with unstable angina.

METHODS

Forty-five patients with unstable angina were allocated into two groups to receive atorvastatin 10 mg/day (n = 24) or no statin (n = 21) for 6 weeks. Circulating levels of von Willebrand Factor (vWF), factor V (fV), protein C (prC), tissue plasminogen activator (tPA) and antithrombin III (ATIII) were measured by enzyme linked immunosorbent assay, by the patients admission and at the 1st and 6th week of the study.

RESULTS

After 1 week of treatment, a significant increase of ATIII (p < 0.05), fV (p < 0.01) and vWF (p < 0.05) was found in the control group, but not in atorvastatin-treated group. Similarly, at 6 weeks after admission, plasma levels of ATIII were still significantly higher than at baseline in controls (p < 0.05), but not in atorvastatin-treated group. Plasma levels of PrtC were significantly increased in both controls (p < 0.01) and atorvastatin-treated patients (p < 0.05) at 1 week, while remained unaffected in atorvastatin-treated group at 6th week. There was no significant difference in the variations of plasma levels of tPA, PrtS and fVII between the two groups at 1 and 6 weeks after admission.

CONCLUSIONS

In normocholesterolemic patients admitted with unstable angina the early administration of atorvastatin, significantly affects von Willebrand factor levels and the expression of liver-derived components of both thrombosis and fibrinolysis system.

摘要

背景

尽管在不稳定型冠状动脉综合征急性期进行他汀类药物治疗可改善预后,但对于血脂正常的不稳定型心绞痛患者,其对血栓形成/纤维蛋白溶解系统的影响仍不清楚。我们评估了短期阿托伐他汀治疗对血脂正常的不稳定型心绞痛患者血栓形成/纤维蛋白溶解标志物的影响。

方法

45例不稳定型心绞痛患者被分为两组,分别接受10毫克/天的阿托伐他汀治疗(n = 24)或不接受他汀类药物治疗(n = 21),为期6周。通过酶联免疫吸附测定法,在患者入院时以及研究的第1周和第6周测量血管性血友病因子(vWF)、凝血因子V(fV)、蛋白C(prC)、组织纤溶酶原激活物(tPA)和抗凝血酶III(ATIII)的循环水平。

结果

治疗1周后,对照组中ATIII(p < 0.05)、fV(p < 0.01)和vWF(p < 0.05)显著升高,而阿托伐他汀治疗组未出现此情况。同样,入院6周后,对照组中ATIII的血浆水平仍显著高于基线水平(p < 0.05),而阿托伐他汀治疗组则未出现此情况。第1周时,对照组(p < 0.01)和阿托伐他汀治疗组患者(p < 0.05)的PrtC血浆水平均显著升高,而在第6周时,阿托伐他汀治疗组未受影响。入院后1周和6周时,两组之间tPA、PrtS和fVII的血浆水平变化无显著差异。

结论

对于血脂正常的不稳定型心绞痛患者,早期给予阿托伐他汀可显著影响血管性血友病因子水平以及血栓形成和纤维蛋白溶解系统中肝脏来源成分的表达。

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