Abstract
Aim. To assess the effects of original statins as monotherapy or in combination with ezetimibe on the levels of proinflammatory cytokines and high-sensitive C-reactive protein (hsCRP) in patients with coronary heart disease (CHD) and hyperlipidemia (HLP). Material and methods. The study included 60 male and female patients with CHD, primary polygenic HLP, and the levels of low-density lipoprotein cholesterol (LDL-CH) of 2,9-4,9 mmol/l. Monotherapy with original statins or ezetimibe lasted for 6 months, while the combination therapy lasted for 3 months. In all randomised patients, the levels of hsCRP, interleukin 6 (IL-6), and monocyte chemotactic protein-1 (MCP-1) were measured at baseline, 12 and 24 weeks after the therapy started. Results. At baseline, median hsCRP levels in the groups of Ezetrol, Zocor, Liprimar, and Crestor monotherapy were 0,5-0,88 mg/l, with no significant dynamics after 3 months of the treatment. Baseline IL-6 levels across the monotherapy groups were 1,94-2,54 pg/ml; at 3 months, there was a non-significant reduction by 7-32 %. After 3 months of the therapy, the decrease in MCP-1 levels was not statistically significant (-1,3-7,7 %). The combined therapy did not result in a significant dynamics of hsCRP concentrations, with the exception of the group receiving Ezetrol and Liprimar. Although the combined therapy further reduced MCP-1 levels (by 30-78 pg/ml), these changes were not statistically significant. No significant difference was observed across statin and Ezetrol groups in terms of their effects on IL-6 and MCP-1 levels. Conclusion. The comparison of the three treatment schemes demonstrated similar, but not statistically significant reduction on the levels of hsCRP, IL-6, and MCP-1. No marked benefits were observed for either monotherapy or combination therapy over 12-24 weeks of the follow-up.
Highlights
Данные наблюдения большой когорты пациентов с острым коронарным синдромом (ОКС) (n=2270), которые были включены в исследование OPUS-TIMI-16 (Orbofiban in Patients winh Unstable coronary Syndromes — Thrombolysis In Myocardial Infarction), показали, что исходно повышенный уровень monocyte chemotactic protein-1 (MCP-1) > 238 пг/мл был связан с увеличенным риском смерти или ИМ [4]
Однако при сравнении трех режимов лечения (таблица 4) были получены однонаправленные (снижение), но недостоверные изменения этого показателя на 8-13 %, при этом преимущества монотерапии эзетимибом или комбинированной терапии статины+эзетимиб отсутствовали
Summary
Медианы исходных уровней вчСРБ в группах (гр.) монотерапии эзетимибом и оригинальными статинами составили 0,5-0,88 мг/л, через 3 мес. При сравнении трех режимов лечения были получены однонаправленные (снижение), но недостоверные изменения в содержании вчСРБ, ИЛ-6, МСР-1, при этом преимущества монотерапии или комбинированной терапии в течение 12-24 нед. Данные наблюдения большой когорты пациентов с ОКС (n=2270), которые были включены в исследование OPUS-TIMI-16 (Orbofiban in Patients winh Unstable coronary Syndromes — Thrombolysis In Myocardial Infarction), показали, что исходно повышенный уровень MCP-1 > 238 пг/мл был связан с увеличенным риском смерти или ИМ (даже после коррекции по ТФР атеросклероза) [4].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
