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The effect of early statin treatment on inflammation and cardiac events in acute coronary syndrome patients with low-density lipoprotein cholesterol

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Abstract

We investigated the effects of atorvastatin on inflammation and cardiac events during the inpatient period and initial 6-month follow-up in acute coronary syndrome (ACS) patients with low low-density lipoprotein (LDL) cholesterol level. One hundred and twelve consecutive ACS patients with LDL cholesterol less than 100 mg/dl were included in the study (mean 78.2 ± 12.3 mg/dl). While 70 randomly selected patients received a dose of 40 mg atorvastatin within the first 24 h on top of their standard treatment as the atorvastatin group, the remaining 42 patients considered as the control group were given the standard treatment only, i.e., without any lipid-lowering drug therapy. Lipid profile, high-sensitivity C-reactive protein (hsCRP), and plasma amyloid A (SAA) levels were measured in all patients within the first 24 h of chest pain, on the 5th day, and in the 6th month. During the inpatient period and subsequent 6-month follow-up, all episodes of angina, reinfarction, revascularization, heart failure, rehospitalization, cardiac mortality, and total number of cardiac events were recorded. In the atorvastatin group, hsCRP and SAA values on the 5th day and in the 6th month compared to the first 24 h were significantly lower than those of the control group (P < 0.0001). Mean LDL cholesterol level was significantly decreased in the atorvastatin group (55.7 ± 17.7 mg/dl), but there was no significant change in the control group at the 6th month. The frequency of heart failure during the inpatient period and angina, unstable angina pectoris, heart failure, and revascularization in the first 6 months were also significantly reduced in the atorvastatin group. Atorvastatin started in the first 24 h reduces inflammation and improves the prognosis during both the inpatient period and the first 6 months of clinical follow-up in ACS patients with low LDL cholesterol levels.

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References

  1. CJ Pepine (2003) ArticleTitleOptimizing lipid management in patients with acute coronary syndromes Am J Cardiol 91 IssueIDsuppl 30B–35B Occurrence Handle10.1016/S0002-9149(02)03290-3 Occurrence Handle1:CAS:528:DC%2BD3sXisVWntL8%3D Occurrence Handle12615296

    Article  CAS  PubMed  Google Scholar 

  2. GJ Blake PM Ridker (2001) ArticleTitleNovel clinical markers of vascular wall inflammation Circ Res 89 763–771 Occurrence Handle1:CAS:528:DC%2BD3MXot1ynu70%3D Occurrence Handle11679405

    CAS  PubMed  Google Scholar 

  3. TP Zwaka V Hombach J Torzewski (2001) ArticleTitleC-reactive protein-mediated low density lipoprotein uptake by macrophages: implications for atherosclerosis Circulation 103 1194–1197 Occurrence Handle1:CAS:528:DC%2BD3MXisFeksLo%3D Occurrence Handle11238260

    CAS  PubMed  Google Scholar 

  4. L Lacoste JY Lam J Hung G Letchacovski CB Solymoss D Waters (1995) ArticleTitleHyperlipidemia and coronary disease: correction of the increased thrombogenic potential with cholesterol reduction Circulation 92 3172–3177 Occurrence Handle1:CAS:528:DyaK28XhslOktQ%3D%3D Occurrence Handle7586300

    CAS  PubMed  Google Scholar 

  5. A Notarbartolo G Davi M Averna CM Barbagallo A Ganci C Giammarresi FP La Placa C Patrono (1995) ArticleTitleInhibition of thromboxane biosynthesis and platelet function by simvastatin in type IIa hypercholesterolemia Arterioscler Thromb 15 247–251 Occurrence Handle1:STN:280:ByqB28fpsFE%3D

    CAS  Google Scholar 

  6. U Laufs V La Fata J Plutzky JK Liao (1998) ArticleTitleUpregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors Circulation 97 1129–1135 Occurrence Handle1:CAS:528:DyaK1cXisVWmsrY%3D Occurrence Handle9537338

    CAS  PubMed  Google Scholar 

  7. PM Ridker N Rifai MA Pfeffer FM Sacks LA Moye S Goldman GC Flaker E Braunwald (1998) ArticleTitleInflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol And Recurrent Events (CARE) Investigators Circulation 98 839–844 Occurrence Handle1:CAS:528:DyaK1cXlvFyhur0%3D Occurrence Handle9738637

    CAS  PubMed  Google Scholar 

  8. InstitutionalAuthorNameScandinavian Simvastatin Survival Study (4S) (1994) ArticleTitleRandomised trial of cholesterol lowering in 4 444 patients with coronary heart disease Lancet 344 1383–1389 Occurrence Handle10.1016/S0140-6736(94)90566-5

    Article  Google Scholar 

  9. InstitutionalAuthorNameThe Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group (1998) ArticleTitlePrevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels N Engl J Med 339 1349–1357 Occurrence Handle10.1056/NEJM199811053391902

    Article  Google Scholar 

  10. FM Sacks MA Pfeffer LA Moye JL Rouleau JD Rutherford TG Cole L Brown JW Warnica JM Arnold CC Wun BR Davis E Braunwald (1996) ArticleTitleThe effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels N Engl J Med 335 1001–1009 Occurrence Handle10.1056/NEJM199610033351401 Occurrence Handle1:CAS:528:DyaK28XmsFWls7c%3D Occurrence Handle8801446

    Article  CAS  PubMed  Google Scholar 

  11. HR Arntz R Agrawal W Wunderlich L Schnitzer R Stern F Fischer HP Schultheiss (2000) ArticleTitleBeneficial effects of pravastatin (6colestyramine/niacin) initiated immediately after a coronary event (the Randomized Lipid-Coronary Artery Disease [L-CAD] Study) Am J Cardiol 86 1293–1298 Occurrence Handle10.1016/S0002-9149(00)01230-3 Occurrence Handle1:CAS:528:DC%2BD3cXoslGgs7k%3D Occurrence Handle11113401

    Article  CAS  PubMed  Google Scholar 

  12. GG Schwartz AG Olsson MD Ezekowitz P Ganz MF Oliver D Waters A Zeiher BR Chaitman S Leslie T Stern InstitutionalAuthorNameMyocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators (2001) ArticleTitleEffects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial JAMA 285 1711–1718 Occurrence Handle10.1001/jama.285.13.1711 Occurrence Handle1:CAS:528:DC%2BD3MXivFGnurc%3D Occurrence Handle11277825

    Article  CAS  PubMed  Google Scholar 

  13. U Stenestrand L Wallentin (2001) ArticleTitleSwedish Register of Cardiac Intensive Care (RIKS-HIA). Early statin treatment following acute myocardial infarction and 1-year survival JAMA 285 430–436 Occurrence Handle10.1001/jama.285.4.430 Occurrence Handle1:CAS:528:DC%2BD3MXhtVehu7c%3D Occurrence Handle11242427

    Article  CAS  PubMed  Google Scholar 

  14. M Kayıkcıoǧlu L Can H Kultursay S Payzın C Turkoglu (2002) ArticleTitleEarly use of pravastatin with acute myocardial infarction undergoing coronary angioplasty Acta Cardiol 57 295–302 Occurrence Handle10.2143/AC.57.4.2005430 Occurrence Handle12222700

    Article  PubMed  Google Scholar 

  15. SM Grundy JI Cleeman CN Merz HB Brewer SuffixJr LT Clark DB Hunninghake RC Pasternak SC Smith SuffixJr NJ Stone (2004) ArticleTitleNational Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines Circulation 110 227–239 Occurrence Handle10.1161/01.CIR.0000133317.49796.0E Occurrence Handle15249516

    Article  PubMed  Google Scholar 

  16. CP Cannon E Braunwald CH McCabe DJ Rader JL Rouleau R Belder SV Joyal KA Hill MA Pfeffer AM Skene InstitutionalAuthorNamePravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators (2004) ArticleTitleIntensive versus moderate lipid lowering with statins after acute coronary syndromes N Engl J Med 350 1495–1504 Occurrence Handle10.1056/NEJMoa040583 Occurrence Handle1:CAS:528:DC%2BD2cXjtVeqtr8%3D Occurrence Handle15007110

    Article  CAS  PubMed  Google Scholar 

  17. F Avanzini G Ferrario L Santoro P Peci P Giani E Santoro MG Franzosi G Tognoni InstitutionalAuthorNameGruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico-3 Investigators (2002) ArticleTitleRisks and benefits of early treatment of acute myocardial infarction with an angiotensin-converting enzyme inhibitor in patients with a history of arterial hypertension: analysis of the GISSI-3 database Am Heart J 144 1018–1025 Occurrence Handle10.1067/mhj.2002.126739 Occurrence Handle1:CAS:528:DC%2BD3sXnvFSq Occurrence Handle12486426

    Article  CAS  PubMed  Google Scholar 

  18. InstitutionalAuthorNameISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group (1995) ArticleTitleISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58 050 patients with suspected acute myocardial infarction Lancet 345 669–685 Occurrence Handle10.1016/S0140-6736(95)90865-X

    Article  Google Scholar 

  19. T Killip J Kimball (1967) ArticleTitleTreatment of myocardial infarction in a coronary care unit: A two year experience with 250 patients Am J Cardiol 20 457 Occurrence Handle10.1016/0002-9149(67)90023-9 Occurrence Handle6059183

    Article  PubMed  Google Scholar 

  20. InstitutionalAuthorNameNew York Heart Association (1994) The Criteria Committee of the New York Heart Association Nomenclature and Criteria for Diagnosis, 9th edn Little Brown Boston

    Google Scholar 

  21. EM Macy TE Hayes RP Tracy (1997) ArticleTitleVariability of measurement of C-reactive protein in healthy subjects: implications for reference interval and epidemiological interval Clin Chem 43 52–58 Occurrence Handle1:CAS:528:DyaK2sXis1Kltg%3D%3D Occurrence Handle8990222

    CAS  PubMed  Google Scholar 

  22. S Poole D Walker RE Gaines Das RJ Gallimore MB Pepys (1998) ArticleTitleThe first international standard for serum amyloid A protein (SAA). Evaluation in an international collaborative study J Immunol Methods 214 1–10 Occurrence Handle10.1016/S0022-1759(98)00057-X Occurrence Handle1:CAS:528:DyaK1cXjvVSksbs%3D Occurrence Handle9692853

    Article  CAS  PubMed  Google Scholar 

  23. T Matsuo K Iwade N Hirata M Yamashita H Ikegami N Tanaka M Aosaki H Kasanuki (2005) ArticleTitleImprovement of arterial stiffness by the antioxidant and anti-inflammatory effects of short-term statin therapy in patients with hypercholesterolemia Heart Vessels 20 8–12 Occurrence Handle10.1007/s00380-004-0793-5 Occurrence Handle15700196

    Article  PubMed  Google Scholar 

  24. Y Luo D Jiang D Wen J Yang L Li (2004) ArticleTitleChanges in serum interleukin-6 and high-sensivity C-reactive protein levels in patients with acute coronary syndrome and their responses to simvastatin Heart Vessels 19 257–262 Occurrence Handle10.1007/s00380-004-0776-6 Occurrence Handle15799170

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Çukurova University School of Medicine, 01330, Adana, Turkey

    Mehmet Kanadaşı, Murat Çaylı, Mustafa Demirtaş, Mesut Demir, Mevlut Koç, Mahir Avkaroǧulları, Yurdaer Dönmez, Ayhan Usal, Cumhur C. Alhan & Mustafa Şan

  2. Department of Biochemistry, Çukurova University School of Medicine, Adana, Turkey

    Tamer İnal

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  1. Mehmet Kanadaşı
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  2. Murat Çaylı
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  3. Mustafa Demirtaş
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Correspondence to Mehmet Kanadaşı.

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Kanadaşı, M., Çaylı, M., Demirtaş, M. et al. The effect of early statin treatment on inflammation and cardiac events in acute coronary syndrome patients with low-density lipoprotein cholesterol. Heart Vessels 21, 291–297 (2006). https://doi.org/10.1007/s00380-005-0901-1

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  • DOI: https://doi.org/10.1007/s00380-005-0901-1

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