Vasoprotective and antiatherosclerotic action of statins in patients with carotid atherosclerosis

Abstract

The results of a pilot clinical study of vasoprotective and antiatherosclerotic effect of simvastatin in 60 patients with carotid atherosclerosis confirmed by ultrasonic duplex scanning are presented. Clinico-instrumental patients assessment included the evaluation of the lipid profile, endothelial function (endothelium-dependent vasodilation of the brachial artery in the reactive hyperemia test), the thickness of the intima-media complex and the morpho-functional state of the atherosclerotic plaques of carotid arteries. The study performed within 12 months. Simvastatin administration in low dose (25 mg daily) leads to improvement of vasodilation capacity, reduction of proinflammatory cytokines production, regression of the thickness of the intima-media complex and increase the volume of atherosclerotic plaques. Secondary to anti-inflammatory action, simvastatin administration caused the conversion of soft plaques to the hard plaques that characterizes their greater stability and reduces the risk of atherothrombosis.

References

  1. Табеева Г.Р. Профилактика инсульта // Справочник поликлинического врача. 2006. № 3.
  2. Рекомендации по вторичной профилактике инсульта // Неотложная терапия. 2004. № 1-2.
  3. Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383-89.
  4. Collins R, Armitage J, Parish S, et al. for the Heart Protection Study Collaborative Group. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet 2004;363:757-67.
  5. Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation 1998;97:1440-45.
  6. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol level. Results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 1998;279:1615-22.
  7. Yrjanheikki J, Koistinaho J, Kettunen M. Long-term protective effect of atorvastatin in permanent focal cerebral ischemia. Brain Res 2005;1052:174-79.
  8. Карпов Ю.А., Сорокин Е.В. Мозговые инсульты: статины эффективны для вторичной профилактики // РМЖ. 2007. Т. 14. № 20. С. 15-21.
  9. Парфенов В.А. Аторвастатин во вторичной профилактике ишемического инсульта // Болезни сердца и сосудов. 2006. Т. 1. № 4.
  10. Amarenco P, Labreuche J, Lavallee P, Touboul P-J. Statin in stroke prevention and carotid atherosclerosis: systematic review and meta-analysis. Stroke 2004;35:2902-09.
  11. Liao JK. Clinical implications for statin pleiotropy. Curr Opin Lipidol 2005;16:624-29.
  12. Switzer JA, Hess DC. Statin therapy for coronary heart disease and its effect on stroke. Curr Atheroscler Rep 2006;8:337-42.
  13. Szapary L, Horvath B, Marton Z, et al. Short-term effect of low-dose atorvastatin on haemorrheological parameters, platelet aggregation and endothelial function in patients with cerebrovascular disease and hyperlipidaemia. CNS Drugs 2004;18:165-72.
  14. Stoll G, Bendszus M. Inflammation and atherosclerosis: novel insights into plaque formation and destabilization. Stroke 2006;37:1923-32.
  15. Minoguchi K, Yokoe T, Tazaki T, Minoguchi H. et al. Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Resp Critical Care Med 2005;172:625-30.
  16. Bots ML. IL-6, carotid plaques predict mortality in elderly. Am J Med 2006;119:519-25.
  17. Ridker PM, Cannon CP, Morrow D, et al. for the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) Investigators C-Reactive Protein Levels and Outcomes after Statin Therapy. N Eng J Med 2005;352:20-28.
  18. Смирнова Е.П., Леонова М.В., Белоусов Ю.Б. и др. Вазопротективное и антиатерогенное действие комбинации аторвастатина и клопидогреля у больных каротидным атеросклерозом // Фарматека. 2007. № 19. С. 64-67.
  19. http://www.pharmateca.ru/cgi-bin/statyi.pl?sid=2411&mid=1085056570&magid=179

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