title: Cardioprotective effect of atorvastatin alone or in combination with remote ischemic preconditioning on the biochemical changes induced by ischemic/reperfusion injury in a mutual prospective study with a clinical and experimental animal arm.
abstract: BACKGROUND
  Atorvastatin and remote ischemic preconditioning (RIPC) have beneficial cardiovascular protective effects. The aim of the study was to investigate possible effect of this drug alone and in combination with RIPC on the biochemical changes induced by ischemic/reperfusion injury (I/R) in a combined study with a clinical and experimental animal arm.
  
  
  METHODS
  Thirty consecutive patients undergoing elective percutaneous coronary intervention (PCI) were divided into three groups (10 each): group I (control group without any preconditioning), group II (patients who were maintained on atorvastatin (80mg/day) for one month before PCI), and group III (similar to group II but PCI was preceded by RIPC). On the other hand, sixty adult male New Zealand white rabbits were divided into 6 groups (10 each): group I (control), group II (sham), group III (I/R as 30min ischemia followed by 120min reperfusion), group IV (regular atorvastatin 10mg/kg for 40days orally followed by I/R), group V (I/R preceded by RIPC) and group VI (similar to group IV but I/R was preceded by RIPC). Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), troponin I (cTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP) were measured in blood for all study groups.
  
  
  RESULTS
  Clinical and experimental parts showed that groups with RIPC combined with atorvastatin pre-treatment showed a synergistic protective effect against I/R injury as evidenced by significant reduction (P<0.001) in the levels of TNF-α, cTnI (in patients) and IL-6, CK-MB and CRP (in rabbits) while the level of NO was significantly (P<0.001) increased compared with other groups.
  
  
  CONCLUSIONS
  Pretreatment with atorvastatin combined with RIPC can exert a synergistic cardioprotective effects by reducing the possible biochemical changes related to ischemic reperfusion injury.
authors: Pharmacology Department, Faculty of Medicine and University Hospital, Assiut University, Assiut. Egypt.
authors: Ehab S
authors: ES
authors: El Desoky
authors: Cardiology Department, Faculty of Medicine and University Hospital, Assiut University, Assiut. Egypt. Electronic address: aymankhairy11@gmail.com.
authors: Ayman K M
authors: AKM
authors: Hassan
authors: Pharmacology Department, Faculty of Medicine and University Hospital, Assiut University, Assiut. Egypt.
authors: Safaa Y
authors: SY
authors: Salem
authors: Pathology Department, Faculty of Medicine and University Hospital, Assiut University, Assiut. Egypt.
authors: Sabah A
authors: SA
authors: Fadil
authors: Pharmacology Department, Faculty of Medicine and University Hospital, Assiut University, Assiut. Egypt.
authors: Amira F
authors: AF
authors: Taha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000069059:Atorvastatin / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D019194:Ischemic Preconditioning / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000517:prevention & control*; D009569:Nitric Oxide / Q000097:blood; D011446:Prospective Studies; D011817:Rabbits; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009569:Nitric Oxide; D002097:C-Reactive Protein; D000069059:Atorvastatin
keywords: Atorvastatin; Biochemical markers; Ischemic reperfusion; Remote ischemic reperfusion