Atorvastatin induces associated reductions in platelet P-selectin, oxidized low-density lipoprotein, and interleukin-6 in patients with coronary artery diseases

Heart Vessels. 2008 Jul;23(4):249-56. doi: 10.1007/s00380-008-1038-9. Epub 2008 Jul 23.

Abstract

The development and progression of atherosclerosis comprises various processes, such as endothelial dysfunction, chronic inflammation, thrombus formation, and lipid profile modification. Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors that have pleiotropic effects in addition to cholesterol-lowering properties. However, the mechanisms of these effects are not completely understood. Here, we investigated whether atorvastatin affects the levels of malondialdehyde-modified low-density lipoprotein (MDALDL), an oxidized LDL, the proinflammatory cytokine interleukin-6 (IL-6), or platelet P-selectin, a marker of platelet activation, relative to that of LDL cholesterol (LDL-C). Forty-eight patients with coronary artery disease and hyperlipidemia were separated into two groups that were administered with (atorvastatin group) or without (control group) atorvastatin. The baseline MDA-LDL level in all participants significantly correlated with LDL-C (r = 0.71, P < 0.01) and apolipoprotein B levels (r = 0.66, P < 0.01). Atorvastatin (10 mg/day) significantly reduced the LDL-C level within 4 weeks and persisted for a further 8 weeks of administration. Atorvastatin also reduced the MDA-LDL level within 4 weeks and further reduced it over the next 8 weeks. Platelet P-selectin expression did not change until 4 weeks of administration and then significantly decreased at 12 weeks, whereas the IL-6 level was gradually, but not significantly, reduced at 12 weeks. In contrast, none of these parameters significantly changed in the control group within these time frames. The reduction (%) in IL-6 between 4 and 12 weeks after atorvastatin administration significantly correlated with that of MDALDL and of platelet P-selectin (r = 0.65, P < 0.05 and r = 0.70, P < 0.05, respectively). These results suggested that the positive effects of atorvastatin on the LDL-C oxidation, platelet activation and inflammation that are involved in atherosclerotic processes are exerted in concert after lowering LDL-C.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Atorvastatin
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism
  • Cholesterol / blood
  • Combined Modality Therapy
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diet therapy
  • Coronary Artery Disease / drug therapy*
  • Female
  • Heptanoic Acids / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diet therapy
  • Hypercholesterolemia / drug therapy*
  • Interleukin-6 / blood*
  • Lipoproteins, LDL / blood*
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • P-Selectin / blood*
  • Pyrroles / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Triglycerides / blood

Substances

  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Interleukin-6
  • Lipoproteins, LDL
  • P-Selectin
  • Pyrroles
  • Triglycerides
  • oxidized low density lipoprotein
  • Malondialdehyde
  • Cholesterol
  • Atorvastatin