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小剂量阿托伐他汀钙联合依洛尤单抗:对冠心病患者调节蛋白、血脂谱及心功能的影响

Low-dose atorvastatin calcium combined with evolocumab: effect on regulatory proteins, lipid profiles, and cardiac function in coronary heart disease patients.

作者信息

Li Ying, Gu Rui, Yan Feng, Liu Zhaoyu, Zhang Xia, Zhao Xiaoxia, Xu Fengquan

机构信息

Department of Cardiology, The First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College Wuhu, China.

Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese Medicine Beijing, China.

出版信息

Am J Transl Res. 2024 Jun 15;16(6):2334-2345. doi: 10.62347/ZGKO3645. eCollection 2024.

Abstract

OBJECTIVE

To assess the effects of combining low-dose atorvastatin calcium with evolocumab on complement regulatory protein levels, lipid profiles, and cardiac function in patients with coronary heart disease (CHD).

METHODS

A prospective randomized controlled study was conducted, with 180 CHD patients enrolled from Guang'anmen Hospital, China Academy of Chinese Medical Sciences, and the Second Hospital of Shanxi Medical University between February 2022 and April 2023. These patients were randomly assigned to either the control group (n = 90), receiving low-dose atorvastatin calcium, or the research group (n = 90), receiving a combination of low-dose atorvastatin calcium and evolocumab. The changes in cardiac function indices, levels of blood lipids and complement proteins, incidence of side effects, and cardiovascular events were compared between the two groups.

RESULTS

After treatment, both groups exhibited reductions in blood lipid levels. However, the research group demonstrated significantly lower levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) compared to the control group (all P < 0.001). Additionally, improvements in cardiac function indices were observed in both groups, with the research group displaying greater enhancements in cardiac output (CO), stroke volume (SV), and left ventricular ejection fraction (LVEF). Furthermore, the levels of complement regulatory proteins, including CD45, CD46, CD55, and CD59, increased in both groups after treatment, with the research group exhibiting significantly higher levels (all P < 0.001). Notably, the research group also exhibited a lower incidence of cardiovascular events.

CONCLUSION

The combined use of low-dose atorvastatin calcium and evolocumab effectively modulates complement regulatory protein levels, optimizes blood lipid profiles, and enhances cardiac function in patients with CHD. This combination therapy represents a promising approach for management of CHD.

摘要

目的

评估低剂量阿托伐他汀钙与依洛尤单抗联合应用对冠心病(CHD)患者补体调节蛋白水平、血脂谱及心功能的影响。

方法

进行一项前瞻性随机对照研究,于2022年2月至2023年4月从中国中医科学院广安门医院、山西医科大学第二医院招募了180例冠心病患者。这些患者被随机分为对照组(n = 90),接受低剂量阿托伐他汀钙治疗,或研究组(n = 90),接受低剂量阿托伐他汀钙与依洛尤单抗联合治疗。比较两组心功能指标、血脂及补体蛋白水平的变化、副作用发生率和心血管事件。

结果

治疗后,两组血脂水平均降低。然而,研究组的总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平显著低于对照组(均P < 0.001)。此外,两组心功能指标均有改善,研究组的心输出量(CO)、每搏输出量(SV)和左心室射血分数(LVEF)改善更明显。此外,治疗后两组补体调节蛋白水平,包括CD45、CD46、CD55和CD59均升高,研究组水平显著更高(均P < 0.001)。值得注意的是,研究组心血管事件发生率也较低。

结论

低剂量阿托伐他汀钙与依洛尤单抗联合使用可有效调节冠心病患者的补体调节蛋白水平,优化血脂谱,增强心功能。这种联合治疗是冠心病管理的一种有前景的方法。

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