Comparison Of Short-term Effects Of Simvastatin And Atorvastatin On Inflammatory Factors In Patients With Acute Coronary Syndrome

Background Acute coronary Syndrome is an important occurrence in the procedure of atheromatosis, which conversion has a direct impact on the patient with coronary heart disease. Investigation thinks the stability of plaque has a decisive action in the acute coronary syndrome. And studies had made clear that statins could improve the endothelium function and stabilize the plaque of ACS .So statins can improve the prognosis of the patients with acute coronary syndrome. But if statins could produce a marked effect in short-term is not clear. Something should be done to make sure whether statins can improve condition in short period in patients with acute coronary syndrome.Objective To observe whether intervention with two different dosage of simvastatin and common dosage of atorvastatin may benefit to plasma levels of high-sensitive C reactive protein (Hs-CRP), homocysteine (Hcy) and von Willebrand factor (vWF) in patients with acute coronary syndrome.Methods Patients of acute coronary syndrome were randomly assigned into four groups: the control group (n=15) treated without lipid-lowering drugs, 20mg (n=15) and 40mg ( n=18) simvastatin group with 3 days of treatment. Before and after the treatment, the plasma levels of Hs-CRP, Hcy, vWF and lipid were detected.Result Treatments of 20mg simvastatin did not induced the significant decrease of Hs-CRP, Hcy and vWF. Compared to the control group, levels of Hs-CRP, Hcy and vWF were markedly reduced by 40mg simvastatin (Hs-CRP 47.0% vs 4.3%, Hcy 36.6% vs 0.9%, vWF 19.0% vs 4.8%, P<0.05).No changes of lipid levels were observed in any group before and after treatment, whilst with 40mg/d simvastatin there were no relation between the decrease percent of Hs-CRP, Hcy or vWF and that of TC or LDL (r=0.229, P=0361; r=0.142, P=0.57A; r=0.131, P=0.605), LDL-C (r= -0.020, P=0.936; r= -0.112, P=0.659; r= -0.321, P=0.194) . No changes of lipid levels were observed in any group before and after treatment, whilst there were no relation between the decrease percent of Hs-CRP, Hcy or vWF and that of TC or LDL (r=-0.127, P=0.639; r=-0.008, P=0.976; r=-0.049, P=0.857), LDL-C (r= -0.278, P=0.281; r=-0.229, P=0.393; r= -0.330, P=0.211) and TG (r=0.026, P= 0.922; r=-0.159, P=0.557; r=-0.029, P= 0.914).Conclusion Treatments with high-dose simvastatin (40mg/d) common-dose atorvastatin(10mg/d) for 3 days could reduce the levels of inflammatory factors and Hcy and improved the function of vascular endothelium, thus it promotes the stabilization of atherosclerotic plaque.