Skip to main content
SpringerLink
Log in

Immediate effect of fluvastatin on lipid levels in acute coronary syndrome

  • Published:
Molecular and Cellular Biochemistry Aims and scope Submit manuscript

Abstract

It is widely assumed that acute benefit of statin therapy is mediated especially by non-lipid effects. The immediate influence of statins on lipid levels in patients with acute coronary syndrome (ACS) is, however, not clear. A total of 64 consecutive patients with ACS were randomized at admission to fluvastatin 80 mg (Group 1, N = 32) or standard therapy without statin (Group 2, N = 32). The levels of total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), and triglycerides (TG) were examined at admission and after 24 h. Baseline characteristics were comparable in both groups. In Group 1, fluvastatin significantly decreased the levels of TC by 14.5%, LDL-C by 17.2%, and HDL-C by 10.0% (P < 0.001); TG were not influenced. In Group 2 only marginal reductions in TC (by 4.1%, P = 0.03) and HDL-C (by 7.5%, P < 0.01) were detected; the levels of LDL-C and TG were not changed. As compared with Group 2, in Group 1 the final levels of TC (P = 0.02) and LDL-C (P = 0.01) were significantly lower. Fluvastatin therapy, when started at admission in patients with ACS, significantly reduces TC and LDL-C already after 24 h. We suggest that the lipid-lowering effect of statins in the therapy of ACS is probably as prompt as non-lipid effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) (1994) Lancet 344(8934):1383–1389

  2. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels (1998) The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl J Med 339(19):1349–1357

  3. Sacks FM, Pfeffer MA, Moye LA et al (1996) The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and recurrent events trial investigators. N Engl J Med 335(14):1001–1009

    Article  PubMed  CAS  Google Scholar 

  4. Ostadal P, Alan D, Vejvoda J (2005) Statins in the first-line therapy of acute coronary syndrome - similar to aspirin? Exp Clin Cardiol 10(1):9–16

    CAS  Google Scholar 

  5. Fang CH, Li JJ, Hui RT (2005) Statin, like aspirin, should be given as early as possible in patients with acute coronary syndrome. Med Hypotheses 64(1):192–196

    Article  PubMed  CAS  Google Scholar 

  6. Wolfrum S, Dendorfer A, Schutt M et al (2004) Simvastatin acutely reduces myocardial reperfusion injury in vivo by activating the phosphatidylinositide 3-kinase/Akt pathway. J Cardiovasc Pharmacol 44(3):348–355

    Article  PubMed  CAS  Google Scholar 

  7. Bell RM, Yellon DM (2003) Atorvastatin, administered at the onset of reperfusion, and independent of lipid lowering, protects the myocardium by up-regulating a pro-survival pathway. J Am Coll Cardiol 41(3):508–515

    Article  PubMed  CAS  Google Scholar 

  8. Hayashidani S, Tsutsui H, Shiomi T et al (2002) Fluvastatin, a 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitor, attenuates left ventricular remodeling and failure after experimental myocardial infarction. Circulation 105(7):868–873

    Article  PubMed  CAS  Google Scholar 

  9. Ostadal P, Alan D, Hajek P et al (2003) The effect of early treatment by cerivastatin on the serum level of C-reactive protein, interleukin-6, and interleukin-8 in the patients with unstable angina and non-Q-wave myocardial infarction. Mol Cell Biochem 246(1-2):45–50

    Article  PubMed  CAS  Google Scholar 

  10. Tousoulis D, Antoniades C, Katsi V et al (2005) The impact of early administration of low-dose atorvastatin treatment on inflammatory process, in patients with unstable angina and low cholesterol level. Int J Cardiol

  11. Macin SM, Perna ER, Farias EF et al (2005) Atorvastatin has an important acute anti-inflammatory effect in patients with acute coronary syndrome: results of a randomized, double-blind, placebo-controlled study. Am Heart J 149(3):451–457

    Article  PubMed  CAS  Google Scholar 

  12. Ray KK, Cannon CP (2005) Early time to benefit with intensive statin treatment: could it be the pleiotropic effects? Am J Cardiol 96(5A):54F–60F

    Article  PubMed  CAS  Google Scholar 

  13. Nair P, Roguin A (2006) Statins and the acute coronary syndrome: ‘the early bird catches the worm’. Int J Clin Pract 60(6):716–727

    Article  PubMed  CAS  Google Scholar 

  14. Kanadasi M, Cayli M, Demirtas M et al (2006) The effect of early statin treatment on inflammation and cardiac events in acute coronary syndrome patients with low-density lipoprotein cholesterol. Heart Vessels 21(5):291–297

    Article  PubMed  Google Scholar 

  15. Zhou T, Zhou SH, Qi SS et al (2006) The effect of atorvastatin on serum myeloperoxidase and CRP levels in patients with acute coronary syndrome. Clin Chim Acta 368(1-2):168–172

    Article  PubMed  CAS  Google Scholar 

  16. Michelena HI, Osorio LA, Citkowitz E (2005) Cholesterol levels after 3 days of high-dose simvastatin in patients at moderate to high risk for coronary events. Int J Cardiol 101(1):111–114

    Article  PubMed  Google Scholar 

  17. Marchesi S, Lupattelli G, Siepi D et al (2000) Short-term atorvastatin treatment improves endothelial function in hypercholesterolemic women. J Cardiovasc Pharmacol 36(5):617–621

    Article  PubMed  CAS  Google Scholar 

  18. Li JJ, Chen MZ, Chen X et al (2003) Rapid effects of simvastatin on lipid profile and C-reactive protein in patients with hypercholesterolemia. Clin Cardiol 26(10):472–476

    Article  PubMed  Google Scholar 

  19. Tsunekawa T, Hayashi T, Kano H et al (2001) Cerivastatin, a hydroxymethylglutaryl coenzyme a reductase inhibitor, improves endothelial function in elderly diabetic patients within 3 days. Circulation 104(4):376–379

    Article  PubMed  CAS  Google Scholar 

  20. Kayikcioglu M, Turkoglu C, Kultursay H et al (1999) The short term results of combined use of pravastatin with thrombolytic therapy in acute myocardial infarction [abstract]. Circulation 100(suppl 1):I-303, Abstract 1586

    Google Scholar 

  21. Schwartz GG, Olsson AG, Ezekowitz MD et al (2001) Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 285(13):1711–1718

    Article  PubMed  CAS  Google Scholar 

  22. Liem AH, van Boven AJ, Veeger NJ et al (2002) Effect of fluvastatin on ischaemia following acute myocardial infarction: a randomized trial. Eur Heart J 23(24):1931–1937

    Article  PubMed  CAS  Google Scholar 

  23. Arntz HR, Agrawal R, Wunderlich W et al (2000) Beneficial effects of pravastatin (+/−colestyramine/niacin) initiated immediately after a coronary event (the randomized Lipid-Coronary Artery Disease [L-CAD] Study). Am J Cardiol 86(12):1293–1298

    Article  PubMed  CAS  Google Scholar 

  24. Cannon CP, Braunwald E, McCabe CH et al (2004) Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 350(15):1495–1504

    Article  PubMed  CAS  Google Scholar 

  25. Thompson PL, Meredith I, Amerena J et al (2004) Effect of pravastatin compared with placebo initiated within 24 h of onset of acute myocardial infarction or unstable angina: the Pravastatin in Acute Coronary Treatment (PACT) trial. Am Heart J 148(1):e2

    Article  PubMed  Google Scholar 

  26. de Lemos JA, Blazing MA, Wiviott SD et al (2004) Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA 292(11):1307–1316

    Article  PubMed  Google Scholar 

  27. Briel M, Schwartz GG, Thompson PL et al (2006) Effects of early treatment with statins on short-term clinical outcomes in acute coronary syndromes: a meta-analysis of randomized controlled trials. JAMA 295(17):2046–2056

    Article  PubMed  CAS  Google Scholar 

  28. Hulten E, Jackson JL, Douglas K et al (2006) The effect of early, intensive statin therapy on acute coronary syndrome: a meta-analysis of randomized controlled trials. Arch Intern Med 166(17):1814–1821

    Article  PubMed  CAS  Google Scholar 

  29. Ostadal P, Alan D, Hajek P et al (2005) Fluvastatin in the therapy of acute coronary syndrome: rationale and design of a multicenter, randomized, double-blind, placebo-controlled trial (The FACS Trial)[ISRCTN81331696]. Curr Control Trials Cardiovasc Med 6(1):4

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study is supported by the grant of the Czech Ministry of Health, Nr. 00000064203 and by the Charles University in Prague Research Project MSM 0021620817, awarded by the Ministry of Education, Youth and Physical Education of the Czech Republic.

Author information

Authors and Affiliations

  1. Department of Cardiology, Charles University in Prague, 2nd Faculty of Medicine & University Hospital Motol, Prague, Czech Republic

    Petr Ostadal, David Alan, Jiri Vejvoda, Peter Blasko & Lucia Martinkovicova

  2. Cardiocenter, Department of Cardiology, Charles University in Prague, 3rd Faculty of Medicine & University Hospital Kralovske Vinohrady, Srobarova 50, Prague, 100 34, Czech Republic

    Petr Ostadal

  3. Department of Clinical Biochemistry and Pathobiochemistry, Charles University in Prague, 2nd Faculty of Medicine & University Hospital Motol, Prague, Czech Republic

    Jana Cepova & Jiri Kukacka

  4. Department of Cardiac Surgery, Charles University in Prague, 2nd Faculty of Medicine & University Hospital Motol, Prague, Czech Republic

    Jan Vojacek

Authors
  1. Petr Ostadal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Alan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiri Vejvoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jana Cepova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jiri Kukacka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Peter Blasko
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lucia Martinkovicova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jan Vojacek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petr Ostadal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ostadal, P., Alan, D., Vejvoda, J. et al. Immediate effect of fluvastatin on lipid levels in acute coronary syndrome. Mol Cell Biochem 306, 19–23 (2007). https://doi.org/10.1007/s11010-007-9549-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11010-007-9549-8

Keywords

Search

Navigation