engleski

The onset of atherosclerosis can be delayed with statins and angiotensin-converting enzyme inhibitors

Aims: The study investigated the role of statin and ACE-inhibitor therapy in the development of atherosclerosis via their effect on C-reactive protein (CRP) and homocysteine (HCY). Methods: A total of 243 type 2 diabetics were studied during a 1-yr. follow-up period. Patients were randomized to receive either atorvastatin (n=59), simvastatin (n=64), pravastatin (n=38), or trandolapril (n=43). The control group included 39 patients. The patients were assigned to groups based on AER /mg/24h/ (<30, 30-300, >300), pulse pressure (PP) (<45, 45-50, 50-65, >65) and body mass index (BMI) (<25, 25-30, >30). Results: ANOVA revealed significant differences in initial CRP and atherogenic index of plasma (AIP) (p=0.01 and p=0.041, respectively) according to AER and BMI (both p<0.001), and in HCY and AIP (both p<0.001) according to PP. Multiple linear regression for CRP, HCY, age, diabetes duration, BMI, AIP, AER and PP showed (p<0.01) BMI and AIP to be independent predictors of CRP, and age, AER and BMI to be independent predictors of HCY (p<0.05). CRP was significantly reduced in the groups treated with atorvastatin (p<0.001), simvastatin (p=0.049) or trandolapril (p=0.012). HCY was significantly reduced in the simvastatin- and pravastatin-treated groups (p=0.015 vs. p=0.002) ; AIP and PP were significantly reduced in the simvastatin- and atorvastatin-treated groups (both p<0.01). A significant reduction (p<0.005) in AER and PP was revealed in the trandolapril group. Conclusions: ACE-inhibitors and statins had a beneficial effect on blood pressure and lipid profile, also attenuating inflammation by reducing CRP and HCY, and consequently delaying the development of atherosclerosis.

C-reactive protein; homocysteine. atherosclerosis; therapy

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