The Effect Of Simvstatin On Endothelial Function And Thrombolysis In Patients With Unstable Angina Pectoris

Background Coronary heart disease (CHD), a common disease which is threateningpeople's health. The unstable angina pectoris (UAP) is one of the serious types of the coronary heart diseases, which does not only become stable angina pectoris, but also lead to acute myocardial infarction. Therefore, there are more and more cardiologists making their efforts to find out the best methods to solve the problems, such as its pathogenesis, pharmacological methods, and intervention therapy. With development of the Evidence-based medicine(EBM), statins have been confirmed that they not only possess significant serum lipids-lowering effect, but also dramatically reduce the mortality and non-causing-death cardiac events. More recently, it is found that statins have much more effective clinical funcitons on the patients with coronary heart disease than that due to their lipids-lowering effect, which makes cardiologists to work out whether statins posses other effects, that has nothing to do with non-lipids regulation function, which will slow down the development of cardiovascular diseases. Atherosclerosis is a chronic inflammatory reaction which relates to the dysfunction of endothelium, inappropriate release of cellular adherence factors, disorder of the thrombolysis, and the like.Objective The study is to explore the effect of simvastatin on serum nitric oxide,endothelin-1, tissue plasminogen activtor(t-PA), and plasminogen activator inhibitor(PAI-l), which are vasodilator, vasoconstrictor, thrombolysis, and antithrombolysis, respectively.Methods According to the standard of the diagnosis and therapy of the UAP made byChina Cardiologist Association and Editorial Board of Chinese Journal of Cardiology, 61 cases with UAP were selected and randomly divided into two groups: (1 Conventional therapeutic group (n=30):all patients except those with contraindication were administrated aspirin, f3 -receptor blockers, nitrates, ACEI and lower molecular heparin through subcutaneous injection. Calcium channel blockers were added to patients withPrinzmetal's Angina. (2)Simvastatin therapeutic group (n=31): based on the conventionaltherapeuty, we added simvastatin 20mg/d to the patients for 12 weeks. Their serum ET-1, NO, and t-PA, PAI-1 were compared with that respectively before and after 12 weeks treatment.Results (1) After 12 weeks simvastatin treatment, total plasma Cholesterol(TC),Triglycerides (TG), Low Density Lipoprotein Cholesterol (LDL-C) decreased and plasma High Density Lipoprotein Cholesterol (HDL-C) increased, there was significantdifference respectively;(2)After simvastatin treatment, serum ET-1 and PAI-1 decreased, NO increased, there was significant difference respectively, the activity of t-PA tended to go up, but there was no statistical significance in it. Compared with conventional therapeutic group, serum ET-1 and PAI-1 decreased, NO increased, with significant difference respectively, t-PA was more effective, however, without any statistical significance.Conclution simvastatin will significantly improve endothelium-dependentvasodilatation function and enhance the effect of plasminogen activator in patients with UAP.