Atorvastatin has an important acute anti-inflammatory effect in patients with acute coronary syndrome: Results of a randomized, double-blind, placebo-controlled study

Macin, Stella M.; Perna, Eduardo R.; Farías, Eduardo; Franciosi, Valeria; Cialzeta, Jorge; Brizuela, Mónica; Medina, Fernanda; Tajer, Carlos; Doval, Hernán C.; Badaracco, R.

doi:10.1016/j.ahj.2004.07.041

Cited by 93 publications

(62 citation statements)

References 39 publications

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“…This suggests that a significant inhibitory effect of atorvastatin treatment takes place when high levels of inflammatory markers are present, but that high dose therapy may decrease inflammation, regardless of baseline level. This is consistent with previous results obtained with atorvastatin and other statins [17,19,42].…”

Section: Discussionsupporting

confidence: 94%

“…However, even the lowest dose, atorvastatin 10 mg was associated with significant reductions in hsCRP levels (SF group 18% (6 weeks) and 21% (12 weeks)). This is consistent with studies in patients with acute coronary syndromes [17]. and hyperlipidemia [15,41].…”

Section: Discussionsupporting

confidence: 92%

“…In addition to their effects on LDL-C, statins have antiinflammatory properties [13,14], as shown by significant reductions in hsCRP levels that appear to be unrelated to the magnitude of LDL-C reduction [15][16][17][18]. Statins are highly effective in reducing the risk of cardiovascular events in both primary and secondary prevention, to a degree that is greater than predicted on the basis of LDL-C lowering alone.…”

Section: Introductionmentioning

confidence: 99%

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Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Gensini¹,

Gori²,

Dilaghi³

et al. 2010

International Journal of Cardiology

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Background: Elevated C-reactive protein (CRP) concentration is a risk factor for cardiovascular events that may add prognostic information. Statin treatment is associated with significant reductions in CRP concentrations, which appear to be unrelated to the magnitude of LDL-cholesterol reduction. We investigated the effect of atorvastatin, across its dose range, on high sensitivity (hs)CRP in subjects at high cardiovascular risk. Methods: ACTFAST was a 12 week, prospective, multicenter, open-label trial in which high-risk subjects were assigned a starting dose of atorvastatin (10,20,40 Results: At baseline, ST subjects had significantly lower hsCRP levels than SF subjects (ST group 2.31, 95% CI 2.15, 2.48 mg/L vs. SF group 3.16, 95% CI 2.98, 3.34 mg/L, p b 0.05). In the SF group, atorvastatin 10 to 80 mg significantly (p b 0.01) reduced hsCRP levels in a dose dependent-manner. In ST group, additional hsCRP reductions were observed over the statin used at baseline, which were not dosedependent. Atorvastatin significantly decreased hsCRP concentrations in subjects with or without diabetes or the metabolic syndrome. Conclusions: Atorvastatin treatment at different doses, particularly 80 mg, significantly reduced hsCRP serum concentrations. This reduction was observed in both SF and ST groups and was independent of the presence of metabolic syndrome and/or diabetes. The beneficial effect of atorvastatin was evident at 6 weeks, supporting the practice of early introduction of higher doses of atorvastatin in high-risk patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Gensini¹,

Gori²,

Dilaghi³

et al. 2010

International Journal of Cardiology

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“…Many recent studies have shown that short-term loading of statins has beneficial pleiotropic cardiovascular effects, which are independent of their lipid-lowering effects (7,8) because statins can only lower the lipid level with long-term treatment. The effects of statins include protection of the endothelium (9), dilation of coronary microvessels (10), reduction of thrombogenesis (11), antiplatelet and anti-inflammatory capabilities (12), and significant lowering of post-PCI intercellular adhesion molecule-1 and E-selectin levels (13). Animal studies have also shown that acute statin loading before reperfusion reduced the area of myocardial infarction (14).…”

Section: Resultsmentioning

confidence: 99%

Effect of different loading doses of atorvastatin on percutaneous coronary intervention for acute coronary syndromes

Sun

Gao

et al. 2010

Canadian Journal of Cardiology

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“…Полученные в последние годы данные позво-ляют говорить о положительном влиянии аторвастатина и на прогноз у больных острым коронарным синдро-мом (ОКС) при назначении его после стабилизации со-стояния пациента [2,3] на течение хронической сер-дечной недостаточности (ХСН) [4] и пароксизмальной формы мерцательной аритмии (фибрилляции пред-сердий) [5]. Также выявлен протективный эффект аторвастатина у больных с хроническими заболеваниями почек и хронической обструктивной болезнью легких (ХОБЛ).…”

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Effect of Genes Slco1b1 and Mdr1 Polymorphism on Atorvastatin Pharmacokinetics and Pharmacodynamics in Patients With Primary Hypercholesterolemia: Results of Pilot Pharmacogenetics Study

Семенов

Sichev

Кукес

2008

Racionalʹnaâ farmakoterapiâ v kardiologii

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Влияние полиморфизма генов SLCO1B1 и MDR1 на фармакокинетику и фармакодинамику аторвастатина у пациентов с первич-ной гиперхолестеринемией. Результаты пилотного фармакогенетического исследования А.В. Семенов, Д.А. Сычев, В.Г. Кукес Кафедра клинической фармакологии и пропедевтики внутренних болезней, Московская медицинская академия им. И.М. Сеченова Цель. Оценить влияние полиморфизма генов SLCO1B1 и MDR1 на фармакокинетику и фармакодинамику аторвастатина у пациентов с пер-вичной гиперхолестеринемией. Материал и методы. В исследовании принял участие 21 пациент (9 мужчин и 14 женщин; средний возраст 57 лет; все -европеоидной расы) с первичной гиперхолестеринемией (по критериям NCEP) с концентрацией общего холестерина крови более 5,9 ммоль/л после 4-недель-ной гиполипидемической диеты. Для оценки фармакокинетики в первый день лечения пациентам назначался аторвастатин в дозе 80 мг с забором проб крови до (0) и после приема препарата. Проведен скрининг на наличие полиморфизма генов MDR1 и SLCO1B1 с помощью полимеразной цепной реакции. Результаты. Выявлена меньшая эффективность лечения у носителей генотипа SLCO1B1 .с521СС по сравнению с другими генотипами, тог-да как полиморфизм гена MDR1 существенно не влиял на эффективность лечения. Не было выявлено связи между генотипом и частотой раз-вития нежелательных лекарственных реакций. Заключение. Носительство полиморфных аллелей генов, кодирующих белки-транспортеры лекарственных средств ( в первую очередь ОАТР-С) может существенно изменять фармакокинетические параметры (AUC) аторвастатина и индивидуальный ответ на лечение. Ключевые слова: полиморфизм генов белков-транспортеров, аторвастатин, фармакогенетика, гиперхолестеринемия. Aim. To study effects of genes SLCO1B1 and MDR1 polymorphism on atorvastatin pharmacokinetics and pharmacodynamics in patients with primary hypercholesterolemia. Material and methods. 21 patients (9 men and 14 women; 57 y.o. in average, all were Caucasians) with primary hypercholesterolemia (NCEP criteria) were involved in the study. All patients had total cholesterol plasma level >5.9 mmol/l after 4-week course of lipid-lowering diet. Atorvastatin (80 mg once daily in the first treatment day) was given to patients for pharmacokinetics estimation. Blood samples for analysis were taken before and after drug administration. Genes SLCO1B1 and MDR1 polymorphism screening was made by polymerase chain reaction. Results. Treatment efficacy in patients with SLCO1B1.с521СС genotype was less than this in patients with other genotypes. Genes MDR1 polymorphism have no influence on treatment efficacy. There is no correlation between genotype and drug adverse effects rate. Conclusion. Polymorphism of genes responsible for protein-transporters (first of all ОАТР-С) can significantly determine drug pharmacokinetic and individual response on atorvastatin therapy.

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Atorvastatin has an important acute anti-inflammatory effect in patients with acute coronary syndrome: Results of a randomized, double-blind, placebo-controlled study

Cited by 93 publications

References 39 publications

Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Effect of different loading doses of atorvastatin on percutaneous coronary intervention for acute coronary syndromes

Effect of Genes Slco1b1 and Mdr1 Polymorphism on Atorvastatin Pharmacokinetics and Pharmacodynamics in Patients With Primary Hypercholesterolemia: Results of Pilot Pharmacogenetics Study

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