Atorvastatin reduces the expression of COX-2 mRNA in peripheral blood monocytes from patients with acute myocardial infarction and modulates the early inflammatory response.
BACKGROUND
We examined the effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI), and the plasma C-reactive protein (CRP) concentrations were also examined.


METHODS
Patients with AMI (n = 40) and with stable coronary heart disease (CHD; n = 18) were registered, and patients with AMI were randomly separated to a group that received routine therapy (group A, n = 20) or to a group that received routine therapy plus atorvastatin at 20 mg/day (group B, n = 20) for a week. Peripheral blood monocytes from patients with AMI both before and after treatment and from patients with stable CHD were isolated and cultured for 24 h. COX-2 mRNA expression was analyzed by reverse transcription-PCR. We measured concentrations of CRP in plasma by ELISA.


RESULTS
COX-2 expression was activated in peripheral blood monocytes from patients with AMI [0.92 (0.13)] compared with patients with stable CHD [0.19 (0.08)]; after a week of treatment, COX-2 expression in group B (reduced by 66%) was obviously lower than in group A (reduced by 24%; P <0.05). Plasma concentrations of CRP from patients with AMI [43.3 (14.9) mg/L] were increased compared with those from patients with stable CHD [1.65 (0.78) mg/L; P <0.05]; after a week of treatment, CRP concentrations in group B (reduced by 62%) were lower than in group A (reduced by 35%; P <0.05). COX-2 expression in peripheral blood monocytes from patients with AMI was positively correlated with plasma CRP concentration (r = 0.662; P <0.05).


CONCLUSIONS
COX-2 may promote acute inflammatory process after AMI. Atorvastatin may improve the antiinflammatory effects through the COX-2 pathway.
Deng
Ping
P
Department of Cardiology, the Second XiangYa Hospital, Central South University, Hunan, People's Republic of China. dengping2115@yahoo.com.cn
Zhao
Shui-ping
SP
Dai
Hai-ying
HY
Guan
Xian-song
XS
Huang
Hong-guang
HG
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000069059:Atorvastatin; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000201:enzymology; D011486:Protein C / Q000378:metabolism; D011758:Pyrroles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000096:biosynthesis*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006538:Heptanoic Acids; D011486:Protein C; D011758:Pyrroles; D012333:RNA, Messenger; D000069059:Atorvastatin; D051546:Cyclooxygenase 2