Short-term atorvastatin treatment during unstable angina in normocholesterolemic patients: Effects on inflammatory markers

Abstract

Unstable angina (UA) is accompanied by increased levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-a), monocytes chemoattractant protein-1 (MCP-1) and soluble vascular cell adhesion molecule (sVCAM-1). Statins reduce mortality and morbitity in patients with CAD, but their effects during and immediately after the acute phase of unstable angina are unknown. Forty-six normocholesterolemic patients (34 males 12 females, aged 64±8 years old) with unstable ungina, were randomly divided into 2 groups and received atorvastatin 10 mg/day (n=24, ATR group) or no statin (n=23, ATR group) for 6 weeks after the incident. Serum levels of IL-6, TNF-a, MCP-1 and sVCAM-1 were measured with ELISA at baseline, at 1 week and at 6 weeks after admission. Baseline, levels of IL-6, TNF-a, MCP-1 and sVCAM-1 were not significantly different between ATR (5.80±0.78 pg/ml, 3.88±0.48 pg/ml, 319±31.0 ng/ml and 474±33.0 ng/ml respectively) and control group (5.90±0.79 pg/ml, 3.3±0.43 pg/ml, 285±18 ng/ml and 429±19.0 ng/ml respectively, p=NS for all). At 1 week, serum levels of IL-6, TNF-a, MCP-a and sVCAM-1 were not significantly altered in ATR (6.65±0.63 pg/ml, 3.73±0.43 pg/ml, 330±26.1 ng/ml and 496±28 ng/ml, p=NS for all compared to baseline) or control group (5.9±0.79 pg/ml, 3.37±0.60 pg/ml, 279±19 ng/ml and 443±19.0 ng/ml, p=NS for all compared to baseline). However, at 6 weeks, IL-6 level was significantly decreased in both ATR (3.32±0.57 pg/ml p<0.001 compared to baseline) and control group (3.51±0.52 pg/ml, p<0.01 compared to control). TNF-a was decreased in both ATR (2.07±0.28 pg/ml, p<0.05) and controls (2.56±0.40 pg/ml). MCP-1 was increased in controls (365±19 ng/ml, p<0.05) but not in ATR (352±22 ng/ml, p=NS). SVCAM-1 was increased control group (474±0.21, p<0.05) but not in atorvastatin-treated group (461±18 pg/ml, p=NS). Low dose atorvastatin treatment modifies inflammatory process in normocholesterolemic patients admitted with unstable angina, by decreasing the expression of MCP-1 and sVCAM-1. At least one week of atorvastatin treatment is required to achieve these beneficial effects.