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LIPID-LOWERING AND PLEIOTROPIC EFFECTS OF ATORVASTATIN IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Aim. To investigate how 6-month atorvastatin treatment affects serum lipid profile, pulmonary function, cytokine profile, and endothelial function in patients with chronic obstructive pulmonary disease (COPD) but without cardiovascular disease (CVD). Materials and Methods. We recruited 83 consecutive male smokers with COPD but without CVD who was prescribed with bronchodilator therapy. Patients were stratified into the two groups: with (n = 42) and without (n = 41) atorvastatin treatment. At the baseline and upon 6 months of atorvastatin (20 mg/day) treatment, we performed spirometry, body plethysmography, brachial artery reactive hyperemia test, lipid profiling, and measurements of serum interleukin (IL)-6, IL-8, tumor necrosis factor-α (TNF-α), and endothelin-1 (ET-1). Cardiovascular risk was evaluated in accordance with the SCORE scale. Results. Upon 6-month treatment with atorvastatin, all patients achieved the target level of low-density lipoprotein cholesterol. Furthermore, treatment significantly decreased cardiovascular risk, improved lung diffusion capacity, increased forced expiration volume in 1 second, enhanced endothelium-dependent dilation, and reduced the level of ET-1 and pro-inflammatory cytokines. Conclusions. 6-month administration of atorvastatin in patients with COPD but without CVD improves serum lipid profile, reduces concentration of pro-inflammatory cytokines, and enhances both pulmonary and endothelial function.

About the Authors

SVETLANA A. Smakotina
Kemerovo State Medical University
Russian Federation


SVETLANA A. Berns
Moscow State University of Medicine and Dentistry
Russian Federation


EVGENIYA B. Gerasimova
Kemerovo Regional Clinical Hospital
Russian Federation


References

1. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации (V пересмотр) // Атеросклероз и дислипидемии. 2012. №4. С.5-52.

2. Reiner Z., Catapano A.L., De Backer G. et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur. Heart J. 2011; 32 (14): 1769-1818.

3. Antoniu S.A. New therapeutic options in the management of COPD-focus on roflumilast. Int. J. Chron. Obstruct. Pulmon. Dis. 2011; (6): 147-155.

4. Арутюнов Г.П. Пациенты с хронической обструктивной болезнью легких: Взгляд кардиолога // Пульмонология и аллергология. 2012. №4. С. 15-18.

5. Agustí A., Edwards L.D., Rennard S.I., MacNee W., Tal-Singer R., Miller B.E. et al. Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS One. 2012; 7 (5): e37483.

6. Авдеев С.Н., Баймаканова Г.Е. Стратегия ведения кардиологического пациента, страдающего ХОБЛ. Кардио-пульмонологические взаимоотношения // Сердце: журнал для практикующих врачей. 2007. Т.6, №6. С. 305-309.

7. Авдеев С.Н., Баймаканов Т.Е. ХОБЛ и сердечно-сосудистые заболевания: механизмы ассоциации // Пульмонология. 2008. №1. С. 5-13.

8. Baigent C., Keech A., Kearney P.M., Blackwell L., Buck G., Pollicino C. et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005; 366 (9493): 1267-1278.

9. Bonetti P.O., Lerman V.O., Napoli C., Lerman A. Statin effects beyond lipid lowering-are they clinically relevant? Eur. Heart J. 2003; 24(3): 225-248.

10. Amarenco P., Bogousslavsky J., Callahan A. 3rd., Goldstein L.B., Hennerici M., Rudolph A.E. et al. High-dose atorvastatin after stroke or transient ischemic attack. N. Engl. J. Med. 2006; 355 (6): 549-559.

11. Daniels K.R., Mansi I.A., Magulick J.P., Oramasionwu C.U., Mortensen E.M., Pugh M.V. et al. The impact of statins on the incidence of bacteremia and pneumonia in military personnel. 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Presentation L1-297. San Francisco September 9-12, 2012.

12. Novack V., MacFadyen J., Malhotra A., Almog Y., Glynn R.J., Ridker P.M. The effect of rosuvastatin on incident pneumonia: results from the JUPITER trial. CMAJ. 2012; 184 (7): E367-372.

13. Vinogradova Y., Coupland C., Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br. J. Gen. Pract. 2011; 61 (592): e742-748.

14. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. Last updated 2011. Available at: http://www.goldcopd.org/. (accessed 08.12.2016).

15. Casanova C., Aguirre-Jaíme A., de Torres J.P., Pinto-Plata V., Baz R., Marin J.M. et al. Longitudinal assessment in COPD patients: multidimensional variability and outcomes. Eur. Respir. J. 2014; 43 (3): 745-753.

16. Young R.P., Hopkins R., Eaton T.E. Pharmacological actions of statins: potential utility in COPD. Eur. Respir. Rev. 2009; 18 (114): 222-232.

17. Keddissi J.I., Younis W.G., Chbeir E.A., Daher N.N., Dernaika T.A., Kinasewitz G.T. The use of statins and lung function in current and former smokers. Chest. 2007; 132 (6): 1764-1771.

18. Саморукова Е.И., Ли В.В., Задионченко В.С., Адашева Т.В., Малиничева Ю.В., Синкин М.В. Плейотропные эффекты розувастатина у больных хронической обструктивной болезнью легких // Лечащий врач. 2013. №7. С. 103-107.

19. Кузубова Н.А., Гичкин А.Ю., Перлей В.Е. Вазорегулирующая функция эндотелия у больных хронической обструктивной болезнью легких и возможности ее медикаментозной коррекции // Вестник современной клинической медицины. 2010. Т. 3, №3. С. 21-26.

20. Ingebrigtsen T.S., Marott J.L., Nordestgaard B.G., Lange P., Hallas J., Vestbo J. Statin use and exacerbations in individuals with chronic obstructive pulmonary disease. Thorax. 2015; 70 (1): 33-40.

21. Mroz R.M., Lisowski P., Tycinska A., Bierla J., Trzeciak P.Z., Minarowski L. et al. Anti-inflammatory effects of atorvastatin treatment in chronic obstructive pulmonary disease. A controlled pilot study. J. Physiol. Pharmacol. 2015; 66 (1): 111-128.


Review

For citations:


Smakotina S.A., Berns S.A., Gerasimova E.B. LIPID-LOWERING AND PLEIOTROPIC EFFECTS OF ATORVASTATIN IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Fundamental and Clinical Medicine. 2017;2(2):33-42. (In Russ.)

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