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小剂量阿托伐他汀对急性冠脉综合征患者炎症标志物水平的影响及其潜在临床价值。

The influence of low dose atorvastatin on inflammatory marker levels in patients with acute coronary syndrome and its potential clinical value.

作者信息

Lewandowski Maciej, Kornacewicz-Jach Zdzisława, Millo Barbara, Zielonka Joanna, Czechowska Małgorzata, Kaliszczak Robert, Płońska Edyta, Goracy Jarosław, Kaźmierczak Jarosław, Naruszewicz Marek

机构信息

Clinic of Cardiology, Medical University, Szczecin, Poland.

出版信息

Cardiol J. 2008;15(4):357-64.

Abstract

BACKGROUND

High-dose statins are used in acute coronary syndromes (ACS) to reduce inflammation. The aim of the study was the evaluation of the influence of low-dose atorvastatin (20 mg) on selected inflammatory parameters and clinical outcomes after ACS.

METHODS

Seventy eight patients (pts) with ACS were randomly divided into group A (39 pts) taking atorvastatin, and group NA (39 pts) not taking any statin for the following six weeks. C-reactive protein (CRP), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor alpha (TNFa) levels were measured on the first and the fifth days and six weeks after ACS.

RESULTS

There was no significant CRP and IL-6 level decrease in group A (CRP--62%; IL-6-73%) or group NA (CRP-44%; IL-6-62%). There was also no significant change in TNFa levels. The MCP-1 level finally reached the level of significant difference (p < 0.04). Cardiovascular events (MACE) and the restenosis rates did not differ between the groups.

CONCLUSIONS

Low-dose atorvastatin does not have a significant influence on cooling down inflammation in ACS, and MCP-1 can be used as an early indicator of statin anti-inflammatory activity. Furthermore, it does not reduce MACE or restenosis rates despite its influence on MCP-1 levels.

摘要

背景

大剂量他汀类药物用于急性冠状动脉综合征(ACS)以减轻炎症。本研究的目的是评估低剂量阿托伐他汀(20毫克)对ACS后选定炎症参数和临床结局的影响。

方法

78例ACS患者被随机分为A组(39例)服用阿托伐他汀,和非A组(39例)在接下来的六周内不服用任何他汀类药物。在ACS后的第一天、第五天和六周测量C反应蛋白(CRP)、白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)和肿瘤坏死因子α(TNFα)水平。

结果

A组(CRP降低62%;IL-6降低73%)或非A组(CRP降低44%;IL-6降低62%)的CRP和IL-6水平均无显著下降。TNFα水平也无显著变化。MCP-1水平最终达到显著差异水平(p<0.04)。两组之间的心血管事件(MACE)和再狭窄率没有差异。

结论

低剂量阿托伐他汀对ACS炎症的减轻没有显著影响,MCP-1可作为他汀类抗炎活性的早期指标。此外,尽管其对MCP-1水平有影响,但它并不能降低MACE或再狭窄率。

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