Efficacy of simvastatin on carotid atherosclerotic plaque and its effects on serum inflammatory factors and cardiocerebrovascular events in elderly patients

Abstract

To investigate the efficacy of simvastatin on carotid atherosclerotic plaque (CAP) and its effects on serum inflammatory factors and cardiocerebrovascular events in elderly patients, 130 elderly patients with CAP were randomly divided into observation (n=65) and control groups (n=65). The control group was treated with 75 mg/day aspirin enteric-coated tablets, and the observation group was administered additional 20 mg/day simvastatin. Serum total cholesterol, triglyceride, and high- and low-density lipoprotein cholesterol levels (evaluated via the endpoint method) were determined in both groups. Furthermore, the length, thickness and number of CAPs was measured using color Doppler ultrasonography. In addition, levels of inflammatory biomarkers including high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide, D-dimer and fibrinogen, as well as change in microemboli count, were also compared After treatment, the observation group exhibited a significant reduction in size, thickness, and number of CAP and intima-media thickness compared with before treatment. However, no significant difference was found in the indicators of CAPs in the control group before and after treatment. The levels of total cholesterol, triglyceride, and low-density lipid cholesterol decreased, while high-density lipid cholesterol increased in the observation group after treatment, with notable changes in the observation group compared with in the control group. Overall response rate was higher in the observation group compared with the control group. TNF-α, IL-6, and hs-CRP levels in the observation group decreased after treatment compared with those before treatment and those in the control group. Furthermore, the rate of microemboli positivity was lower in the observation group than in the control group. Moreover, the overall incidence of acute cardiocerebrovascular events was lower in the observation group than in the control group. Therefore, it was demonstrated that simvastatin can reduce blood lipid levels, decrease the quantity and size of plaques, alleviate inflammatory response, reduce microemboli formation and reduce the risk of cardiocerebrovascular events in elderly patients with CAP.

An Evaluation of Plasma TNF, VEGF-A, and IL-6 Determination as a Risk Marker of Atherosclerotic Vascular Damage in Early-Onset CAD Patients

“…In a study by Andersson et al [ 50 ], plaque size was associated with increased plasma TNF levels in subjects aged 70 years. In elderly patients, the length, thickness, and number of carotid atherosclerotic plaques with plasma TNF levels decreased after statin treatment [ 51 ]. On the other hand, in a GWAS study, no SNP in the TNF gene was associated with carotid intima–media thickness in hypertensive subjects from British Caucasian families [ 52 ].…”

The Effects of Giving Coconut Milk on Aortic Wall Thickness of Rats (Rattus norvegicus strain Wistar) Fed with High Fat Diet (HFD)

“…Coconut milk's effects follow other all-natural ingredients like neem leaf extract, which can prevent 88.5% of atherosclerosis (Jannah, Isdadiyanto, and Sitasiwi 2020). Simvastatin, a common drug frequently used to treat atherosclerosis, is within 89.80% of (Zhang et al, 2021).…”

A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

“…Based on imaging indices of plaque vulnerability, such as PET scans [47,[48][49][50]52] and carotid plaque echogenicity [53,54], most of those studies suggested an improvement in plaque stability after statin administration, accompanied by a significant reduction in inflammatory biomarkers. Those studies used the most known inflammatory biomarkers, like CRP [47][48][49][53][54][55][56][57][58][59], interleukin (IL)-6 [53,[55][56][57]59], tumor necrosis factor (TNF)-a [49,54,56,59], and monocyte chemoattractant protein-1 [49]. Nevertheless, two studies [52,58] failed to demonstrate the stabilizing effects of statins despite their anti-inflammatory action while other studies failed to find any effect of statins on the aforementioned anti-inflammatory biomarkers at all.…”