Effect Of Statin On Soluble Plasma OX40L Level In Patients With Acute Coronary Syndrome

BackgroudAccumulated evidences indicate that atherosclerosis is chronic inflammatory disease. Inflammation and immune activation are the basic pathogenic mechanism in cardiovascular diseases. OX40/OX401igand interaction is an important signal pathway to activate T cell. Recent studies have showed relationship between OX40L and atherosclerosis. Our previous study found that plasma sOX40L level was markedly increased in patients with acute coronary syndromes compared to health control. Plasma sOX40L was positively correlated with CRP, the most important inflammatory index in atherosclerosis, suggesting the additive significance in predicting of plaque stability.Statin has been used as a primary therapy to atherosclerosis disease by decreasing serum low-density lipoprotein cholesterol (LDL-C) levels. In addition to the lipid lowering effect, the anti-inflamatory role of statin was also contributing to the antiatherogenic mechanism. Many clinic trials have confirmed that the beneficial effect of Statin was related to its effect on CRP reduction. However, there is no report on the role of statin in OX40L, a new inflammation index for coronary heart disease.ObjectiveTo investigate the effect of stain with different dosage on sOX40L and hs-CRP levels in patients with acute coronary syndrome.MethodFourty seven patients with acute coronary syndrome were randomly assigned to low dose(10mg/d) and high dose(20mg/d) atovastatin and were followed up for 4 weeks. Plasma sOX40L and hs-CRP levels were analysed before entry and after 4 weeks intervention..ResultPlasma sOX40L and hs-CRP baseline levels at entry were 27.69±10.52 ng/L, 28.24±10.01ng/L,11.69±7.09mg/L , and 11.91±6.36mg/L, respectively, which were singnificantly higher than healthy control subjects of our previous study. After 4 weeks treatment, sOX40L levels were decreased significantly in both low dose atovastatin group (21.99±8.12ng/L, P<0.05) and high dose atovastatin group (17.51±4.84ng/L, P<0.05) , with a reduction of 20.6% and 38.0% respectively. Significant decreases were also seen in hs-CRP levels in both low dose statin group (32.3% reduction, P<0.05) and high dose statin group (55.8% reduction, P < 0.05) . Singnificantly positive correlations were found between sOX40L levels and hs-CRP levels before (R=0.765, P=0.00) and after intervention (R=0.742, P=0.00).Conclusion1. Plasma sOX40L sand hs-CRP levels were significantly increased in patients with ACS compared to previous controls.2. Atovastatin therapy significantly decreases sOX40L and hs-CRP levels in dose dependent fashion.3. Like hs-CRP, sOX40L may be another index for the evaluation of statin effect..