Preview

Cardiovascular Therapy and Prevention

Advanced search

Anti-inflammatory effects of low- and high-dose atorvastatin therapy in patients with coronary heart disease and rheumatoid arthritis

Abstract

Aim. To assess the dynamics of an inflammatory marker, C-reactive protein (CRP), and lipid profile during 3-month high- and low-dose atorvastatin therapy (40 mg/d and 10 mg/d) in patients with rheumatoid arthritis (RA) or coronary heart disease (CHD) and moderate hyperlipidemia (HLP).
Material and methods. The study included 64 male and female patients: 40 with CHD and 24 with RA, aged 45-60 years, with moderate HLP and positive CRP reaction. Atorvastatin therapy effectiveness was assessed by decrease in CRP, total cholesterol (TCH) and low-density lipoprotein CH (LDL-CH) levels, comparing to baseline concentrations.
Results. During high- and low-dose atorvastatin therapy, 84% and 44% of CHD patients, respectively, achieved target LDL-CH levels (< 2,6 mmol/l). Among RA patients, these figures were 67% and 50%, respectively. Triglycerides and high-density lipoprotein CH dynamics was insignificant in each group. Maximal reduction in CRP level was observed among CHD patients with initially elevated CRP concentration and RA patients receiving high-dose atorvastatin therapy (reduction by 20% and 65%, respectively); in all the other subgroups, CRP dynamics was insignificant.
Conclusion.
Statins reduced CRP concentration in RA patients more effectively than in CHD individuals, possibly, due to initially higher CRP levels among the former.

About the Authors

V. S. Tutunov
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical complex,Federal Agency on High Medical Technologies
Russian Federation


T. V. Popkova
Rheumatology Institute, Russian Academy of Medical Sciences. Moscow
Russian Federation


D. S. Novikova
Rheumatology Institute, Russian Academy of Medical Sciences. Moscow
Russian Federation


E. L. Nasonov
Rheumatology Institute, Russian Academy of Medical Sciences. Moscow
Russian Federation


V. V. Kukharchuk
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical complex,Federal Agency on High Medical Technologies
Russian Federation


References

1. Ross R. Atherosclerosis – an inflammatory disease. N Engl J Med 1999; 340: 115–26.

2. Sattar N, McCarey DW, Capell H, Mclnnes IB. Explaining how high-grade systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003; 108: 2957–63.

3. McCarey DW, McInnes IB, Madhok R, et al. Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomized placebo-controlled trial. The Lancet 2004; 363: 2015–21.

4. Попкова Т.В., Алекберова З.С., Александрова Е.Н. и др. Опыт применения ловастатина (Медостатин®) у пациентов с системной красной волчанкой и ревматоидным артритом. РМЖ 2005; 13(7): 400–2.

5. Okamoto H, Koizumi K, Kamitsuji S, et al. Beneficial Action of Statins in Patients with Rheumatoid Arthritis in a Large Observational Cohort. J Rheumatol 2007; 34: 964–8.

6. Nissen SE. For the REVERSAL Investigators. Comparison of Intensive Versus Moderate Lipid Lowering on the Progression of Coronary Atherosclerosis Measured by Intravascular Ultrasound: A Randomized Controlled Trial. Circulation 2003; 108: 2723.

7. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthr Rheum 1988; 3: 315–24.

8. Friedwald WT, Levy RJ, Fredrickson DS. Estimation of the calculation of LDL cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.

9. Markers of Inflammation and Cardiovascular disease. Application to Clinical and Public Practice. A statement for Healthcare Professionals from the Centers for disease Control and Prevention and the American Heart Association. Circulation 2003; 107: 499–511.

10. Насонов Е.Л. Проблема атеротромбоза в ревматологии. Вестник РАМН 2003; 7: 6–10

11. Насонов Е.Л. Иммунологические маркеры атеросклероза. Тер архив 2002; 5: 80–5.

12. Szmitko PE, Wang CH, Weisel RD, et al. New markers of inflammation and endothelial cell activation, part I. Circulation 2003; 108: 1917–23.

13. Ridker PM, Cook N. Clinical usefulness of very high and very low levels of C-reactive protein across the full range of Framingham Risk Score. Circulation 2004; 109: 1955–9.


Review

For citations:


Tutunov V.S., Popkova T.V., Novikova D.S., Nasonov E.L., Kukharchuk V.V. Anti-inflammatory effects of low- and high-dose atorvastatin therapy in patients with coronary heart disease and rheumatoid arthritis. Cardiovascular Therapy and Prevention. 2008;7(5):43-48. (In Russ.)

Views: 809


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)