(3S-5S-6E)-7-[3-(4-fluorophenyl)-1-(propan-2-yl)-1H-indol-2-yl]-3-5-dihydroxyhept-6-enoic-acid and Syndrome

Patients with acute coronary syndrome (ACS) are at high risk for recurrent coronary events, sudden death, and all-cause mortality. Conventional revascularization therapies reduce the risk of further ischemia but do not affect the underlying atherosclerotic disease. Statins have a proven record in the secondary prevention of coronary heart disease. Furthermore, statins have been shown to exert varying degrees of pleiotropic effects, which may stabilize vulnerable atherosclerotic plaques. A compelling body of evidence from randomized controlled trials demonstrates that high-dose, potent statin therapy initiated immediately after an acute coronary event can significantly reduce early as well as longer-term morbidity and mortality. Furthermore, high-dose, potent statin therapy displays a reasonable safety profile. National guidelines now recommend that in patients with ACS, statin therapy should be initiated in hospital prior to discharge, irrespective of baseline low-density lipoprotein cholesterol levels, to improve clinical outcomes. Every effort should be made to ensure all eligible patients with ACS are initiated and maintained on statin therapy.

Topics: Angina, Unstable; Atorvastatin; Cholesterol, HDL; Cholesterol, LDL; Fatty Acids, Monounsaturated; Fluvastatin; Heptanoic Acids; Hospitalization; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Indoles; Myocardial Ischemia; Pravastatin; Pyrroles; Syndrome; Treatment Outcome

Inflammation promotes acute coronary syndromes (ACS) and ensuing clinical complications. It is well known that statins decrease the risk of coronary events and may benefit the stabilization of atherosclerotic plaque with their anti-inflammatory effects. We investigated the effects of different doses of fluvastatin on serum concentrations of high-sensitive C-reaction protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) in the early phase of ACS.. We prospectively randomized 60 patients with ACS to 3 groups: (1) group A (n=20): were given routine therapy; (2) group B (n=20): were administrated routine therapy with 40 mg/d oral fluvastatin; (3) group C (n=20): received routine therapy with 80 mg/d oral fluvastatin. Twenty patients with stable coronary heart disease served as controls. The following-up period was 7 days. By immunoturbidimetric assay and ELISA methods the serum concentrations of hs-CRP and TNF-alpha were measured before and after therapy.. (1) The serum concentrations of hs-CRP and TNF-alpha in patients with ACS was significantly higher than those in the control group (P<0.05). (2) After 1 week of therapy, the serum concentrations of hs-CRP and TNF-alpha were significantly lower in group B and group C (all P<0.01), especially in group C. (3) The serum concentrations of hs-CRP and TNF-alpha did not correlate to the concentrations of TC, TG, LDL-C, or HDL-C.. Early fluvastatin intervention decreases dose-dependently the serum concentrations of hs-CRP and TNF-alpha of patients with ACS. The high-dose fluvastatin invention may play a stronger anti-inflammatory effect in ACS patients. The anti-inflammatory effect of fluvastatin may be beyond the lipid lowering.

Topics: Acute Disease; Biomarkers; C-Reactive Protein; Coronary Disease; Dose-Response Relationship, Drug; Fatty Acids, Monounsaturated; Female; Fluvastatin; Humans; Indoles; Inflammation Mediators; Lipid Metabolism; Male; Middle Aged; Syndrome; Time Factors; Tumor Necrosis Factor-alpha

Currently available data and clinical observations which suggest that there is a pathogenetic relationship between hypertension, diabetes mellitus, and atherosclerosis have provided a concept of the X syndrome, by which hypertensive patients, mainly males, have impaired insulin tolerance along with hyperinsulinemia and concurrent atherogenic disorders of lipid metabolism. The paper discussed the specific pathogenetic mechanisms, clinical manifestations, and prospects for drug correction of the metabolic syndrome. The treatment of arterial hypertension with the calcium antagonist Lomir has indicated there are no negative changes as a control of non-insulin-dependent diabetes mellitus in the presence of effective correction of arterial hypertension and atherogenic dyslipidemias. With the monotherapy of essential hypertension concurrent with hypercholesterolemia with the alpha 1-adrenoblocker Doxazosin, in addition to the agent's high antihypertensive effects, the authors noted its favourable action on lipid spectral parameters and platelet functional activity. There is abundant evidence for the use of specific hypolipidemic agents in patients with essential hypertensive refractory to current antihypertensive drugs. The data obtained with the use of Lescol (fluvastatin) in patients with hypertensive disease and hypercholesterolemia suggest that by substantially reducing the levels of total cholesterol, triglycerides, low density lipoprotein cholesterol and its transport protein apo B does not deteriorate the quality of correction of arterial hypertension in this group of patients.

Topics: Anticholesteremic Agents; Arteriosclerosis; Diabetes Mellitus; Diabetes Mellitus, Type 2; Doxazosin; Enzyme Inhibitors; Fatty Acids, Monounsaturated; Female; Fluvastatin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Hypertension; Indoles; Insulin Resistance; Isradipine; Lipid Metabolism; Male; Middle Aged; Syndrome