Lewandowski Maciej, Kornacewicz-Jach Zdzisława, Millo Barbara, Zielonka Joanna, Czechowska Małgorzata, Kaliszczak Robert, Płońska Edyta, Goracy Jarosław, Kaźmierczak Jarosław, Naruszewicz Marek
Clinic of Cardiology, Medical University, Szczecin, Poland.
Cardiol J. 2008;15(4):357-64.
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.
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.
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.
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.
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。
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。
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。
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。