Arian Anahita, Moghadam Sayyed Gholamreza Mortazavi, Kazemi Toba, Hajihosseini Morteza
Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
Department of Internal Medicine, Pulmonary Division, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran.
J Res Pharm Pract. 2017 Jan-Mar;6(1):27-30. doi: 10.4103/2279-042X.200985.
Pulmonary hypertension is a serious complication in patients suffering from chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the effects of atorvastatin in reducing pulmonary arterial pressure in COPD patients.
This double-blind, randomized trial was conducted on 42 known cases of COPD with systolic pulmonary arterial pressure of more than 25 mmHg. The patients were randomly assigned into two groups, 21 patients with atorvastatin treatment (40 mg/daily for 6 months) and 21 patients without receiving atorvastatin. All the patients participated voluntarily and provided written informed consent. The trial was registered in the Iranian Registry of Clinical Trials. Pulmonary pressure was also anticipated by Doppler echocardiography with peak pressure gradient of tricuspid regurgitation. Both groups were tested with echocardiography to measure systolic pulmonary pressure at baseline and posttreatment. Statistical analysis includes Chi-square, Student's -test, and Wilcoxon test. < 0.05 was considered statistically significant.
The mean age was 65.8 ± 11.5 years for atorvastatin group and 63.7 ± 7.6 years for control group ( = 0.45). Baseline and posttreatment mean systolic pulmonary artery pressure (PAP) levels in the atorvastatin group were 48.9 ± 3.3 and 38.4 ± 1.9 mmHg, respectively ( = 0.007). In the control group, mean systolic PAP levels at baseline and 6 months later were 45.6 ± 3.1 and 38.9 ± 2.4 mmHg, respectively ( = 0.073). The patients treated with atorvastatin showed significant decrease in total cholesterol ( = 0.001) and low-density lipoprotein cholesterol ( = 0.008).
A 40 mg dose of atorvastatin daily for 6 months may have beneficial effects in reducing PAP in patients with COPD. Further studies are necessary to find long-term effects of statins in COPD patients.
肺动脉高压是慢性阻塞性肺疾病（COPD）患者的一种严重并发症。本研究旨在探讨阿托伐他汀对降低COPD患者肺动脉压的作用。
本双盲随机试验针对42例已知的收缩期肺动脉压超过25 mmHg的COPD患者进行。患者被随机分为两组，21例接受阿托伐他汀治疗（40 mg/每日，共6个月），21例未接受阿托伐他汀治疗。所有患者均自愿参与并提供书面知情同意书。该试验已在伊朗临床试验注册中心注册。还通过多普勒超声心动图测量三尖瓣反流的峰值压力梯度来预估肺动脉压。两组均在基线和治疗后进行超声心动图检查以测量收缩期肺动脉压。统计分析包括卡方检验、学生t检验和威尔科克森检验。P < 0.05被认为具有统计学意义。
阿托伐他汀组的平均年龄为65.8 ± 11.5岁，对照组为63.7 ± 7.6岁（P = 0.45）。阿托伐他汀组基线和治疗后的平均收缩期肺动脉压（PAP）水平分别为48.9 ± 3.3和38.4 ± 1.9 mmHg（P = 0.007）。对照组基线和6个月后的平均收缩期PAP水平分别为45.6 ± 3.1和38.9 ± 2.4 mmHg（P = 0.073）。接受阿托伐他汀治疗的患者总胆固醇（P = 0.001）和低密度脂蛋白胆固醇（P = 0.008）显著降低。
每日40 mg剂量的阿托伐他汀治疗6个月可能对降低COPD患者的PAP有有益作用。有必要进一步研究他汀类药物对COPD患者的长期影响。
