Кардиоваскулярная терапия и профилактика (Dec 2008)

Lipid-lowering and pleiotropic effects of rosuvastatin in patients with acute myocardial infarction

  • N. A. Dzhaiani,
  • E. V. Ilyina,
  • A. G. Kochetov,
  • S. N. Tereshchenko

Journal volume & issue
Vol. 7, no. 7
pp. 91 – 97

Abstract

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Aim. To study lipid-lowering and pleiotropic effects of rosuvastatin in patients with acute myocardial infarction (MI).Materials and methods. The study included 47 patients in the first 24 hours of Q-wave MI: 25 (53,2%) men and 22 (46,8%) women; mean age 60±1,9 years. Group I (n=26) additionally received rosuvastatin (R), 10 mg/d in the first 24 hours of MI, Group II (n=21) received standard therapy only, but no statins. Follow-up period lasted for 10 months. After 21 days and 10 months, all patients underwent veloergometry (VEM) and echocardiography (EchoCG). At Days 1 and 21 and 10 months later, lipid profile and levels of inflammatory markers (C-reactive protein, CRP, macrophage inflammatory protein, interleukin-6, tumor necrosis factor (TNF) alpha, and brain natriuretic peptide (BNP) were assessed.Results. In Group I, post-MI angina attacks were less frequent than in Group II (61,5% vs. 76,2%, р>0,05). Both groups were similar in terms of cardiac arrhythmia incidence. No recurrent MIs were registered in Group I, with 2 events in Group II. Heart failure progression took place in 3,9% and 9,5% (р>0,05), respectively. Three and 4 deaths were registered in Groups I and II, respectively. Ejection fraction increased by 10,3% in Group I, reducing by 5,5% in Group II (р=0,05). In contrast to Group II, substantial lipid-lowering effect was observed in Group I. Positive dynamics persisted by the end of the follow-up period. In Group I, CRP level reduced by 45% at day 21 (р<0,001) and by 37,0% (р<0,001) 10 months later, comparing to the baseline level; in Group II, these figures were, respectively, 20,7% (р>0,05) and 22,6% (р>0,05). TNF-alpha level significantly decreased in Group I, but not in Group II. BNP dynamics was similar in both groups.Conclusion. Early R administration in acute MI improved post-MI clinical course, increased physical stress tolerability reduced the incidence of recurrent MI and death. In addition to its lipid-lowering effects, R decreased inflammatory marker levels (CRP, TNF-alpha).

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