Abstract
High dose statin medication in acute coronary syndrome cases is a therapy which lowers mortality and morbidity rates. Interleukin-6 (IL-6) is produced in higher amounts in acute myocardial infarction (MI) and facilitates myocardial damage. However, secretion of nitric oxide (NO) is depleted. We aimed to compare the effects of conventional dose (10-40 mg/day) and aggressive dose (80 mg/day) atorvastatin medications on IL-6 and NO levels in patients with primary percutaneous transluminal coronary angioplasty (PTCA) intervention after acute MI. 50 patients (8 females, 42 males) with the diagnosis of acute MI with ST segment elevation enrolled to the study. Primary PTCA intervention was performed on these patients and consequently either conventional dose (10 to 40 mg/day) or aggressive dose (80 mg/day) atorvastatin medications were given to the patients. Three months later, plasma IL-6 and NO levels were determined and alterations in the groups were evaluated. IL-6 levels decreased from 24.34 ± 12.04 to 11.40 ± 5.79 pg/ml and from 29.62 ± 17.38 to 12.51 ± 8.95 pg/ ml in conventional dose and aggressive dose regimens respectively (p<0.001). However, NO concentrations increased from 22.90 ± 8.24 to 31.70 ± 7.56 µM in conventional dose and from 19.37 ± 5.60 µM to 34.15 ± 9.60 µM in aggressive dose groups (p < 0.001). The effects of aggressive dose atorvastatin medication on IL-6 and NO levels were similar to conventional dose application in cases with ST segment elevation acute MI. Key words: Atorvastatin, interleukin-6, nitric oxide, myocardial infarction.
Highlights
Acute myocardial infarction (MI) is still an important cause of mortality and morbidity despite of advances in medical therapies and interventional cardiology in recent years (Sabel, 2000)
We aimed to compare the effects of conventional dose (10-40 mg/day) and aggressive dose (80 mg/day) atorvastatin medications on IL-6 and nitric oxide (NO) levels in patients with primary percutaneous transluminal coronary angioplasty (PTCA) intervention after acute MI. 50 patients (8 females, 42 males) with the diagnosis of acute MI with ST segment elevation enrolled to the study
50 patients (42 males, 8 females) who were diagnosed as acute MI with ST segment elevation in Cardiology Department of Selcuk University Meram Medical Faculty were enrolled to this study
Summary
Acute myocardial infarction (MI) is still an important cause of mortality and morbidity despite of advances in medical therapies and interventional cardiology in recent years (Sabel, 2000). The major pathophysiology of acute coronary syndromes (ACS) is summarized as vulnerable plaque, increased inflammation and hypercoagulability. For this reason, anti-inflammatory therapies such as statins and angiotensin converting enzyme inhibitors and anti-platelet therapies such as heparin and clopidogrel are primarily used in ACS without ST segment elevation and percutaneus intervention was postponed as possible as until the cooling vulnerable plaque. High dose statin medication becomes a routine application in most cardiology clinics independent of lipid profiles in ACS in recent years.
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