Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/475
Type: Artigo de periódico
Title: Timing and Dose of Statin Therapy Define Its Impact on Inflammatory and Endothelial Responses During Myocardial Infarction
Author: SPOSITO, Andrei C.
SANTOS, Simone N.
FARIA, Eliana Cotta de
ABDALLA, Dulcineia S. P.
SILVA, Luiza P. da
SOARES, Alexandre A. Sousa
JAPIASSU, Andre V. T.
SILVA, Jose C. Quinaglia e
RAMIRES, Jose A. F.
COELHO, Otavio Rizzi
Abstract: Objective-Clinical trials of statins during myocardial infarction (MI) have differed in their therapeutic regimes and generated conflicting results. This study evaluated the role of the timing and potency of statin therapy on its potential mechanisms of benefit during MI. Methods and Results-ST-elevation MI patients (n = 125) were allocated into 5 groups: no statin; 20, 40, or 80 mg/day simvastatin starting at admission; or 80 mg/day simvastatin 48 hours after admission. After 7 days, all patients switched their treatment to 20 mg/day simvastatin for an additional 3 weeks and then underwent flow-mediated dilation in the brachial artery. As of the second day, C-reactive protein (CRP) differed between non-statin users (12.0 +/- 4.1 mg/L) and patients treated with 20 (8.5 +/- 4.0 mg/L), 40 (3.8 +/- 2.5 mg/L), and 80 mg/day (1.4 +/- 1.5 mg/L), and the daily differences remained significant until the seventh day (P < 0.0001). The higher the statin dose, the lower the elevation of interleukin-2 and tumor necrosis factor-alpha, the greater the reduction of 8-isoprostane and low-density lipoprotein(-), and the greater the increase in nitrate/nitrite levels during the first 5 days (P < 0.001). Later initiation of statin was less effective than its early introduction in relation to attenuation of CRP, interleukin-2, tumor necrosis factor-alpha, 8-isoprostane, and low-density lipoprotein(-), as well as in increase in nitrate/nitrite levels (P < 0.0001). At the 30th day, there was no longer a difference in lipid profile or CRP between groups; the flow-mediated dilation, however, was proportional to the initial statin dose and was higher for those who started the treatment early (P = 0.001). Conclusion-This study demonstrates that the timing and potency of statin treatment during MI are key elements for their main mechanisms of benefit.
Subject: acute coronary syndromes
cytokines
endothelial function
Country: Estados Unidos
Editor: LIPPINCOTT WILLIAMS & WILKINS
Citation: ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, v.31, n.5, p.1240-1246, 2011
Rights: fechado
Identifier DOI: 10.1161/ATVBAHA.110.218685
Address: http://dx.doi.org/10.1161/ATVBAHA.110.218685
http://apps.isiknowledge.com/InboundService.do?Func=Frame&product=WOS&action=retrieve&SrcApp=EndNote&UT=000289720800043&Init=Yes&SrcAuth=ResearchSoft&mode=FullRecord
Date Issue: 2011
Appears in Collections:FCM - Artigos e Materiais de Revistas Científicas

Files in This Item:
File Description SizeFormat 
art_SPOSITO_Timing_and_Dose_of_Statin_Therapy_Define_2011.pdfpublished version970.74 kBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.