The Change of Cholesterol Level and IL-6, CRP in Unstable Angina Patients with Hypercholesterolemia after Low Dose Simvastatin Therapy

ABSTRACT

BACKGROUND AND OBJECTIVES: Cardiovascular mortality in patients with atherosclerosis can be reduced by treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors. This proven effect is probably due, not only to the cholesterol lowering effect, but also to the non-lipid-lowering mechanisms elicited by the action of statins. These results, however, were achieved with high or usual doses of statin therapy, whereas similar results with low dose statins are rare. The aims of this study wereas to investigate the changes ofin cholesterol level and the inflammatory markers, Interleukin-6(IL-6), and C-Reactive protein (CRP), in unstable angina patients with hypercholesterolemia, using low dose simvastatin therapy. SUBJECTS AND METHODS: Eighteen unstable angina patients (55+/-6 years, M F=10 8, Baunwald class IIIb) with hypercholesterolemia (a LDL -cholesterol level over 100 mg/dL) were evaluated. A Llow dose of simvastatin (5 mg) was administrated for 4 weeks. The changes of total cholesterol, LDL-cholesterol, triglyceride, HDL-cholesterol and the inflammatory markers, IL-6, and CRP, were all elevated from the baseline following 4 weeks of treatment. RESULTS: The baseline mean values of total cholesterol, LDL-cholesterol, triglyceride, and HDL-cholesterol were 237.1+/-56.9 mg/dL, 131.9+/-39.0 mg/dL, 168.3+/-20.4 mg/dL, and 50.0+/-3.8 mg/dL, respectively. The baseline mean values of IL-6 and hs CRP were 6.842+/-6.661 pg/mL, and 0.866+/-1.083 mg/dL, respectively. Following the 4 weeks of simvastatin treatment, the levels of total cholesterol, LDL- cholesterol, triglyceride, and HDL-cholesterol were 200.8+/-47.5 mg/dL, 101.6+/-35.4 mg/dlL, 155.8+/-18.6 mg/dL, and 47.0+/-2.3 mg/dL, respectively, giving percentage changes of -17.6% (p0.05), and -2.1% (p>0.05), respectively. Following the 4 weeks of treatment, the levels of IL-6 and hs CRP were 6.955+/-5.555 pg/mL, and 0.753+/-0.571 mg/dL, respectively, giving percentage changes of 51.8 (p>0.05), and 36.5% (p>0.05), respectively. There was no significant correlation between the level of LDL-cholesterol and the levels of IL-6, or hs CRP at the baseline, or post-treatment. There was also no significant correlation between the change of LDL-cholesterol and the changes of IL-6 or hs CRP levels during the simvastatin therapy. There was no significant correlation between the levels of IL-6 and hs CRP at the baseline or ost-treatment. CONCLUSION: Our data showed that in patients with unstable angina patients with coupled with hypercholesterolemia, low dose statin therapy has a cholesterol lowering effect, but no effect on inflammation.