Effects of short-term anti-inflammatory therapy on endothelial function in patients with non-ST-segment elevation acute coronary syndrome.
The aim was to assess the impact of the short-term anti-inflammatory therapy on coronary endothelial function in non-ST-segment elevation acute coronary syndrome patients. In 30 patients, coronary endothelial function was assessed by acetylcholine test. Vessel response was calculated as a percent change of mean lumen diameter (MLD). Then patients were randomized into three groups: A (n = 11) placebo, B (n = 11) 80 mg atorvastatin, C (n = 8) 80 mg atorvastatin and 25 mg rofecoxib. After 7 days control test was performed. Recovery of coronary endothelial function was calculated as delta in percent changes of MLD between Days 1 and 7. On Day 1, percent change of MLD between baseline and maximum acetylcholine did not differentiate the groups: -20 ± 3.5% in A, -25 ± 3.9% in B and -26 ± 3.7% in C, P = .20. On Day 7, percentage changes in MLD were as follows: -21 ± 3.9% in A, -15 ± 3.0% in B and -10 ± 4.0% in C, P=.002. The delta in percentage change in MLD between Days 1 and 7 were as follows: -1% in A, + 10% in B and +16% in C, P = .02. In conclusion, short-term, anti-inflammatory therapy with high-dose atorvastatin and selective cyclooxygenase-2 inhibitor improves coronary endothelial function within 7 days in non-ST-segment elevation acute coronary syndrome patients.
Department of Interventional Cardiology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Michał
M
Chyrchel
Dariusz
D
Dudek
Lukasz
L
Rzeszutko
Artur
A
Dziewierz
Bernadeta
B
Chyrchel
Tomasz
T
Rakowski
Jacek S
JS
Dubiel
D000109:Acetylcholine; D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000069059:Atorvastatin; D003331:Coronary Vessels / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D018836:Inflammation Mediators / Q000097:blood; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011044:Poland; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D013450:Sulfones / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents
D052246:Cyclooxygenase 2 Inhibitors; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D007783:Lactones; D011758:Pyrroles; D013450:Sulfones; D014665:Vasodilator Agents; C116926:rofecoxib; D000069059:Atorvastatin; D000109:Acetylcholine