Effect of conventional and more aggressive rosuvastatin treatment on markers of endothelial activation

Abstract

Treatment of hypercholesterolemia with HMGCoA reductase inhibitors results in an earlier reduction of morbidity and mortality than expected from trials using conventional cholesterol-lowering therapies. Possible explanations for this effect include improvement of endothelial function, plaque stabilization, and inhibition of the inflammatory response associated with atherosclerosis. In this study we assessed the effects of low and moderate dose rosuvastatin treatment, on circulating markers of endothelial activation in patients admitted for acute coronary syndromes without ST segment elevation. Thirty patients with unstable angina and non ST segment elevation myocardial infarction were randomized into two groups, and received rosuvastatin 10 mg/day (n =16) or rosuvastatin 20 mg/day (n =14) for 12 weeks. Circulating levels of soluble vascular cell adhesion molecule (sVCAM-1) and inter cellular adhesion molecule-1 (sICAM-1) were measured at admission, and at the end of the study. Lipid values were significantly reduced in both treatment groups, but with significantly greater reduction in the aggressively treated group. Serum levels of sICAM-1 and sVCAM- 1 were significantly decreased in both rosuvastatin-treated groups during 12 weeks of follow-up with a more pronounced decrease in the more aggressively treated group. Therefore, rosuvastatin modulates endothelial activation in patients after acute coronary syndromes.

Keywords

• soluble adhesion molecules
• statins
• acute coronary syndrome
• inflammation