Drugs and lifestyle for the treatment and prevention of coronary artery disease: comparative analysis of the scientific basis

Luz, Protásio Lemos da; Nishiyama, Marcelo; Chagas, Antônio Carlos Palandri

doi:10.1590/s0100-879x2011007500111

Cited by 14 publications

(5 citation statements)

References 70 publications

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“…These facts support the importance of analyses of therapeutic interventions to interfere with EAT [15]. Pioglitazone and simvastatin have pleiotropic effects and reduce pro-inflammatory markers and improve insulin sensitivity [16-18].…”

Section: Introductionmentioning

confidence: 83%

Synergistic anti-inflammatory effect: simvastatin and pioglitazone reduce inflammatory markers of plasma and epicardial adipose tissue of coronary patients with metabolic syndrome

Grosso

Oliveira

Higuchi

et al. 2014

Diabetol Metab Syndr

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BackgroundThe inappropriate secretion of adipocytokines plays a critical role in chronic inflammatory states associated with obesity-linked type 2 diabetes and atherosclerosis. The pleiotropic actions of simvastatin and pioglitazone on epicardial adipose tissue (EAT) are unknown. This study assessed the anti-inflammatory actions of simvastatin and pioglitazone on EAT in patients with coronary artery disease (CAD) and metabolic syndrome (MS).MethodsA total of 73 patients with multivessel CAD who underwent elective bypass grafting were non-randomly allocated to one of four subgroups: Control (n = 17), simvastatin (20 mg/day, n = 20), pioglitazone (15 mg or 30 mg/day, n = 18), or simvastatin + pioglitazone (20 mg/day + 30 mg/day, respectively, n = 18); 20 valvar patients were also included. EAT samples were obtained during surgery. The infiltration of macrophages and lymphocytes and cytokines secretion were investigated using immunohistochemical staining and compared to plasma inflammatory biomarkers.ResultsSimvastatin significantly reduced plasma interleukin-6, leptin, resistin and monocyte chemoattractant protein-1 (p < 0.001 for all); pioglitazone reduced interleukin-6, tumoral necrose factor-alpha, resistin and matrix metalloproteinase-9 (p < 0.001 for all). Simvastatin + pioglitazone treatment further reduced plasmatic variables, including interleukin-6, tumoral necrose factor-alpha, resistin, asymmetric dimethylarginine and metalloproteinase-9 vs. the control group (p < 0.001). Higher plasma adiponectin and lower high sensitivity C-reactive protein concentrations were found simultaneously in the combined treatment group. A positive correlation between the mean percentage systemic and tissue cytokines was observed after treatments. T- and B-lymphocytes and macrophages clusters were observed in the fat fragments of patients treated with simvastatin for the first time.ConclusionsPioglitazone, simvastatin or combination treatment substantially reduced EAT and plasma inflammatory markers in CAD and MS patients. These tissue effects may contribute to the control of coronary atherosclerosis progression.

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Section: Introductionmentioning

confidence: 83%

Synergistic anti-inflammatory effect: simvastatin and pioglitazone reduce inflammatory markers of plasma and epicardial adipose tissue of coronary patients with metabolic syndrome

Grosso

Oliveira

Higuchi

et al. 2014

Diabetol Metab Syndr

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“…In a review article on factors associated with coronary artery disease, Da Luz et al 15 conclude that among the main risk factors, tobacco stands out. A retrospective study 16 that evaluated the risk of mediastinitis in 500 patients undergoing myocardial revascularization surgery, the incidence of mediastinitis was 28 (5.6%) with a mortality rate of eight (1.8%), with smoking conferring a two-fold higher risk for this outcome.…”

Section: Prado Et Al Overview On Tobacco Smoking 2010-2012mentioning

confidence: 99%

Tabagismo: o que tem sido abordado em periódicos brasileiros

Prado¹,

Lombardi²,

Miethke-Morais³

et al. 2012

Arq. Bras. Cardiol.

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“…El conjunto de medidas farmacológicas, dietéticas y de estilo de vida para controlar los factores de riesgo de enfermedades cerebrovasculares han demostrado una eficacia, en términos de mortalidad y morbilidad, sin duda superior a la alcanzada por la suma de todos los procedimientos terapéuticos utilizados en la fase aguda de la enfermedad [1,2]. Sin embargo, su implementación en la práctica clínica habitual dista mucho de resultar óptima, aunque los resultados reflejados en la bibliografía son dispares [3][4][5][6][7][8][9][10].…”

Section: Introductionunclassified

“…A pesar de que parece comprobado que la modificación de estilos de vida con riesgo cerebrovascular es más eficaz que la introducción de fármacos [11], su implementación en la clínica es considerablemente menor [10]. Las guías recomiendan iniciar lo antes posible la prevención primaria y, en el caso de la prevención secundaria, debe instaurarse durante el tiempo de hospitalización [5].…”

Section: Introductionunclassified

Cumplimiento de las medidas de prevención de factores de riesgo vascular en pacientes ingresados con ictus agudo. Análisis de un registro multicéntrico: registro EPICES (III)

Blanco

Vivancos-Mora²,

Castillo³

2012

RevNeurol

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Drugs and lifestyle for the treatment and prevention of coronary artery disease: comparative analysis of the scientific basis

Cited by 14 publications

References 70 publications

Synergistic anti-inflammatory effect: simvastatin and pioglitazone reduce inflammatory markers of plasma and epicardial adipose tissue of coronary patients with metabolic syndrome

Synergistic anti-inflammatory effect: simvastatin and pioglitazone reduce inflammatory markers of plasma and epicardial adipose tissue of coronary patients with metabolic syndrome

Tabagismo: o que tem sido abordado em periódicos brasileiros

Cumplimiento de las medidas de prevención de factores de riesgo vascular en pacientes ingresados con ictus agudo. Análisis de un registro multicéntrico: registro EPICES (III)

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