Effect of intensive lipid-lowering therapy on the imbalance between inflammatory and anti-inflammtory responses in patients with acute coronary syndrome / 中国医师进修杂志

ABSTRACT

Objective To investigate the effect of intensive lipid-lowering therapy on the imbalance between inflammatory and anti-inflammatory responses in patients with acute coronary syndrome (ACS).Methods Observed serum levels of hs-CRP and IL-IO in 82 patients with ACS, 17 patients with stable angina, and 22 controls. Forty-one patients with ACS were randomized to take either atorvastatin 10 mg/d (standard lipid-lowering therapy) or atorvastatin 40 mg/d (intensive lipid-lowering therapy) for one month in addition to their routine anti-anginal treatment. Serum levels of hs-CRP, blood lipids, IL-10 were investigat-ed.IL-10 was measured by ELISA. Results The level of hs-CRP in patients with ACS [(11.10 ± 14.30)mg/L] was higher than that in patients with stable angina [(2.47 ± 2.72) mg/L]and controls [(2.34 ± 4.22)mg/L] (P all < 0.05 ). The level of IL- 10 was lower in ACS patients [( 3.94 ± 1.91 ) ng/L] compared with those who had stable angina [(6.31 ± 4.26) ng/L] and controls [(7.76 ± 2.82) ng/L], Pan <0.05. The level of hs-CRP in patients with ACS was decreased and IL-10 was increased after one month treatment with atorvastatin (P < 0.05).The effect of atorvastatin 40 mg/d was more effective than that of atorvastatin 10 mg/d.Conclusions Patients with ACS have higher level of hs-CRP and lower level of IL-10 than those with sta-ble angina. This finding suggests that imbalance of inflammatory and anti-inflammatory responses is related with aggravation of atherosclerotic disease. Intensive lipid-lowering therapy is more effective than standard lipid-lowering therapy on ameliorating the imbalance.