The influence of low dose atorvastatin on inflammatory marker levels in patients with acute coronary syndrome and its potential clinical value

Cardiol J. 2008;15(4):357-64.

Abstract

Background: High-dose statins are used in acute coronary syndromes (ACS) to reduce inflammation. The aim of the study was the evaluation of the influence of low-dose atorvastatin (20 mg) on selected inflammatory parameters and clinical outcomes after ACS.

Methods: Seventy eight patients (pts) with ACS were randomly divided into group A (39 pts) taking atorvastatin, and group NA (39 pts) not taking any statin for the following six weeks. C-reactive protein (CRP), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor alpha (TNFa) levels were measured on the first and the fifth days and six weeks after ACS.

Results: There was no significant CRP and IL-6 level decrease in group A (CRP--62%; IL-6-73%) or group NA (CRP-44%; IL-6-62%). There was also no significant change in TNFa levels. The MCP-1 level finally reached the level of significant difference (p < 0.04). Cardiovascular events (MACE) and the restenosis rates did not differ between the groups.

Conclusions: Low-dose atorvastatin does not have a significant influence on cooling down inflammation in ACS, and MCP-1 can be used as an early indicator of statin anti-inflammatory activity. Furthermore, it does not reduce MACE or restenosis rates despite its influence on MCP-1 levels.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / drug therapy*
  • Anticholesteremic Agents / administration & dosage*
  • Atorvastatin
  • C-Reactive Protein / analysis
  • Chemokine CCL2 / blood
  • Coronary Angiography
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / epidemiology
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Heptanoic Acids / administration & dosage*
  • Humans
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Probability
  • Pyrroles / administration & dosage*
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Anticholesteremic Agents
  • Chemokine CCL2
  • Heptanoic Acids
  • Inflammation Mediators
  • Interleukin-6
  • Pyrroles
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Atorvastatin