Pre‐loading therapy with statins in patients with angina and acute coronary syndromes undergoing PCI

Λαμπρόπουλος, Κωνσταντίνος; Megalou, Aikaterini; Bazoukis, George; Tse, Gary; Manolis, Antonis S.

doi:10.1111/joic.12421

Cited by 19 publications

(16 citation statements)

References 44 publications

(46 reference statements)

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“…These effects include preserving endothelial function, stabilizing arterial plaque, scavenging free radicals, and inhibiting proliferation, inflammation, and apoptosis [8]. A meta-analysis of 13 randomized studies showed statin pre-treatment was associated with reduced peri-procedural myocardial infarction and a 44% risk reduction in major adverse cardiovascular events at 30-d irrespective of clinical presentation [9], and similar findings were also found in recent studies [10,11]. The American College of Cardiology, American Heart Association, and European Society of Cardiology have suggested that statins should be used as the secondary prevention following acute myocardial infarction (AMI).…”

Section: Introductionsupporting

confidence: 53%

Cardioprotection of Rosuvastatin Pre-conditioning on Myocardial Ischemia / Reperfusion Injury in a Rat Model

Zhang

Hou

et al. 2019

Braz. arch. biol. technol.

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This study aimed to investigate the cardioprotection of rosuvastatin pre-conditioning (R-Pre) in a rat model of myocardial ischemia / reperfusion (I/R). Male SD rats were assigned into three groups: sham group, I/R group and R-Pre group. Rats in I/R group and R-Pre group received ischemia for 30 min and reperfusion for 2 h. In R-Pre group, rats received intragastrical administration with rosuvastatin at 5 mg/kg once daily for 1 week. After 2-h reperfusion, the cardiac function was detected by ultrasonography; the blood was collected for biochemical analysis; the heart was collected for the TUNEL staining and immunohistochemistry for Bcl-2 and Bax. Our results showed rosuvastatin HIGHLIGHTS • Rosuvastatin pre-conditioning protects the heart against I/R injury. • Rosuvastatin pre-conditioning attenuates oxidative stress and cell apoptosis in the I/R heart. 2 Zhang P.; et al.

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Section: Introductionsupporting

confidence: 53%

Cardioprotection of Rosuvastatin Pre-conditioning on Myocardial Ischemia / Reperfusion Injury in a Rat Model

Zhang

Hou

et al. 2019

Braz. arch. biol. technol.

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“…A study with rosuvastatin loading in the elderly with an ACS that had a PCI can attenuate the increase in hsCRP, CK-MB, and cTnI, decrease myocardial injury and inflammatory reaction caused by PCI, and improve left ventricular function 30 days after PCI [ 72 ]. Similar were the effects of all potent statins [ 73 ]. Moreover, in patients that undergo PCI, statin therapy is effective at reducing the risk of contrast-induced acute kidney injury and its short- mid- long-term adverse effects related to CVD events [ 74 - 77 ].…”

Section: Greace Atorvastatin and Coronary Heart Disease Evaluation (Gmentioning

confidence: 76%

Reduction of Vascular Inflammation, LDL-C, or Both for the Protection from Cardiovascular Events?

Reklou

Doumas

Imprialos

et al. 2018

TOCMJ

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Background:Low density lipoprotein cholesterol (LDL-C) and low grade arterial inflammation are key pathogenic factors for atherosclerosis and its manifestation, cardiovascular disease (CVD).Objective:In this narrative review we assessed if decreasing LDL-C levels or inflammation or both is more effective in reducing CVD events.Results:In the Scandinavian Simvastatin Survival Study (4S), all statin trials of the 90s’ and the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) the benefit came from the LDL-C reduction. In the GREak and Atorvastatin Coronary heart disease Evaluation (GREACE), the Treating to New Targets (TNT), and the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trials both mechanisms in combination produced significant benefits. In the Atorvastatin for Reduction of MYocardial Damage during Angioplasty (ARMYDA) trials and the Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) with a human antibody targeting IL-1β with no lipid lowering effect, the reduction in arterial inflammation played the only beneficial role because there was no change in lipids levels.Conclusion:Both LDL-C and inflammation reduction are beneficial to the reduction of CVD risk. However, canakinumab is a very expensive drug that only induced a 15% reduction in CVD events, thus drastically reducing the possibility for it to be used in clinical practice. Besides, canakinumab is associated with increased infections, some fatal. A potent statin with anti-inflammatory effects is probably the best choice for the majority of those needing hypolipidaemic drug therapy.

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“…Additional basic science studies are needed to better elucidate the underlying molecular mechanisms through which trimetazidine exerts its actions. Thirdly, given the benefit of statin pretreatment for patients with stable angina and acute coronary syndrome undergoing PCI [31], future studies can explore the potential synergistic effects of trimetazidine and statin pretreatment in this patient population. Fourthly, we did not conduct a subgroup analysis according to TIMI flow restoration and thrombus burden, which might also have effect on endothelial damage and myocardial injury.…”

Section: Discussionmentioning

confidence: 99%

Effects of Trimetazidine Pretreatment on Endothelial Dysfunction and Myocardial Injury in Unstable Angina Patients Undergoing Percutaneous Coronary Intervention

Shao

Shi

Tse

et al. 2019

Cardiology Research and Practice

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Objectives. Trimetazidine is an anti-ischemic medication licensed for the treatment of angina pectoris. However, the molecular mechanisms underlying its action remain incompletely elucidated. In this study, therefore, we examined the potential beneficial effects of trimetazidine on myocardial injury and endothelial dysfunction in patients with unstable angina in the perioperative period of percutaneous coronary intervention (PCI). Methods. A total of 97 patients with unstable angina were randomly divided into trimetazidine (n = 48) and control (n = 49) groups. All subjects received standard medical therapy. The trimetazidine group additionally received 20 mg trimetazidine three times daily 24 hours before and after PCI. Serum levels of creatine kinase-muscle/brain (CK-MB), cardiac troponin I (cTnI), heart-type fatty acid-binding protein (h-FABP), von Willebrand factor (vWF), and nitric oxide (NO) were measured before and the morning following PCI. Results. In the control group, levels of CK-MB, cTnI, and vWF were significantly elevated (P<0.05) and NO level was decreased after PCI (P<0.05). By contrast, no significant changes in the levels of these proteins were observed in the trimetazidine group after PCI (P>0.05). Moreover, h-FABP levels were not significantly altered after PCI whether in the control or in the trimetazidine group (P>0.05). Finally, a time-dependent increase in the levels of h-FABP from 0 to 6 hours after PCI, followed by a progressive decline, was observed (P<0.05). Conclusions. PCI induces endothelial dysfunction and myocardial damage in patients with unstable angina. Trimetazidine therapy in the perioperative period can reduce this damage.

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Pre‐loading therapy with statins in patients with angina and acute coronary syndromes undergoing PCI

Cited by 19 publications

References 44 publications

Cardioprotection of Rosuvastatin Pre-conditioning on Myocardial Ischemia / Reperfusion Injury in a Rat Model

Cardioprotection of Rosuvastatin Pre-conditioning on Myocardial Ischemia / Reperfusion Injury in a Rat Model

Reduction of Vascular Inflammation, LDL-C, or Both for the Protection from Cardiovascular Events?

Effects of Trimetazidine Pretreatment on Endothelial Dysfunction and Myocardial Injury in Unstable Angina Patients Undergoing Percutaneous Coronary Intervention

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