EARLY AND LATE EFFECT OF HIGH DOSE ATORVASTATIN AND LOW DOSE ATORVASTATIN ON SERUM C - REACTIVE PROTEIN REDUCTION IN NON ST ELEVATION MYOCARDIAL INFARCTION

سال انتشار: 1387
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 122

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شناسه ملی سند علمی:

JR_RYA-4-1_003

تاریخ نمایه سازی: 3 شهریور 1401

چکیده مقاله:

Abstract    INTRODUCTION: Inflammation is now recognized to play an important role at all stages of the atherogenic process that are precursors of myocardial infarction (MI). hs-CRP is one of this markers of inflammation and Statins have both lipid lowering and anti inflammatory effects and it is proposed that aggressive statins treatment can cause lower serum CRP levels. In this study, we compared intensive and moderate atorvastatin treatment effects on mean serum CRP reduction.    METHODS: This study is a double-blind clinical trial. Some patients who were up ۲۱ years old and recently suffered non-ST elevation MI during ۲۴ hours and went to the emergency department of Feiz hospital and/or Chamran hospital and were confined to bed in the CCU were entered in study. A total number of ۵۰ patients were divided to two groups of equal number: A-۲۵ patients under treatment with ۸۰ mg Atorvastatin B-۲۵ patients under treatment with ۲۰ mg Atorvastatin. The examinations hs-CRP and lipid profile were done at admission to CCU, discharge from hospital and two months after treatments and results compared in two groups.    RESULTS: It was specified that in group treated with ۸۰ mg atorvastatin ۱۲ patients (۴۸%) were males and ۹ patients (۵۲%) were females and mean age was ۶۰.۱ ± ۱۳.۴ years. In group treated with ۲۰mg atorvastatin, ۱۶ patients (۶۴%) were males and ۹ patients (۳۶%) were males and mean age was ۵۹.۶ ± ۱۱.۲ years. In group treated with ۸۰mg atorvastatin mean CRP at CCU admission (baseline), discharge and two months latter was ۷ ± ۵.۵, ۵.۳ ± ۴.۱ and ۲.۳ ± ۴.۳ respectively and in group treated with ۲۰mg atorvastatin was ۷.۱ ± ۸.۳, ۵.۷ ± ۷.۴ and ۳.۵ ± ۵.۱ respectively. Mean  serum LDL (Low density lipoprotein) in patients before and after treatment in group treated with ۸۰ mg atorvastatin was ۱۳۴.۲ ± ۳۳.۲ and ۱۱۷.۵ ± ۳۱.۹ and  in   group  treated  with  ۲۰ mg  atorvastatin  was  ۱۴۱.۰۷ ± ۳۳.۴ and ۱۲۶.۴ ± ۳۲.۵. Mean serum CRP decreased in both groups after treatment but mean CRP decreased to lower levels in patients treated with ۸۰mg atorvastatin either at discharge from hospital (P = ۰.۳۲) or two months after treatment(P = ۰.۰۲) compared patients treated with ۲۰mg atorvastatin and this difference between two groups was more significant two months after treatment than at discharge. Also serum LDL was decrease in both groups after treatment but no significant difference was detected (P = ۰.۷۷). With Pearson correlation there was correlation between the percent reductions in LDL cholesterol and in CRP levels only for the total patients (P < ۰.۰۰۱), not for the high dose atorvastatin group alone or the low dose atorvastatin group alone (P > ۰.۰۵).    CONCLUSION: high dose statins cause lower serum CRP levels and their effect on lowering CRP is separated from their lipid lowering effects and is due to their anti inflammatory effects.      Keywords: atorvastatin, CRP, MI, st elevation MI

نویسندگان

Masoumeh Sadeghi

Associate Professor of Cardiology, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan.

Narges Sadat Razavi

Resident of cardiology, Isfahan University of Medical Sciences, Isfahan.

Nizal Sarrafzadegan

Professor of Cardiology, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan.

Mahzad Saeedifar

Isfahan University of Medical Sciences, Isfahan.

Mohammad Talaee

Researcher Methodology and statistic consultant, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan.