Fasudil On Unstable Angina Pectoris, C-Reactive Protein, Endothelin, Endothelin, Nitric Oxide

ObjectiveUnstable angina pectoris is a common disease of Cardiology, arterioscler-osis is the main pathogenesis, studies have shown, arteriosclerosis plaque stability, mainly related to blood vessel wall inflammation and vascular endothelial function.Fasudil is a compound of isoquinoline sulfonamide, inhibit the protein kinase C to achieve the relaxation of blood vessels,Strong anti-vascular spasm and expansion of the role of serum CRP at the came time inhibit the activity of vascular endothelial function.Therefore,in theory applied fasudil for the treatment of unstable angina pectoris is useful,however,from clinical trials need to make further study confirmed that patients with UAP fasudil treatment benefits,clarify the inflammation and vascular endothelial function in the role of UAP.In the past more than at home and abroad for the prevention and treatment of acute ischemic stroke,while the treatment of unstable angina pectoris reported relatively rare.The issue in the traditional treatment of unstable angina based on the increase with Rho kinase inhibitor fasudil, before and after treatment by measuring plasma C-reactive protein,endothelin, nitric oxide concentration changes, record fasudil treatment improved the symptoms of angina pectoris, angina attack frequency and duration of observation of fasudil on the the role of unstable angina, and described its mechanism.MethodsRandomly selected 60 patients with unstable angina(34men,26 women;age 52.5-66.9years). The patients all correspond to the diagnosis criteria of UAP in WHO,and by coronary angiography confirmed the presence of coronary stenosis and meet diagnostic criteria for coronary artery disease.The following disease were excluded:such as infectious disease,tumor,heart failure,diabetes,the patient with hepatic or renal impairment.The selected patients were randomly divided into 2 groups:the fasudil therapeutic group(n=30,18 men,12 women; age 53.5-65.9years)and conventional therapeutic group(n=30,16 men,14 women; age 52.5-66.9 years); And age, sex, hypertension, heart rate, blood pressure, serum lipid, CK peak value and drug uses between fasudil and routine group were not significant differences. The other thirty healthy people were recruited as control group. Both groups were all treated by routine therapy:nitrates,β-receptor blockers, calcium antagonists, statins lipid-lowering drugs and anticoagulant drugs. on this basis, the fasudil group were given 30 mg fasudil twice a day, all patients in the two groups were not given anti-inflammatory drugs, then C-reactive protein, endothelin, nitric oxide in blood lipid were measured before treatment. The level of C-reactive protein was determined with immune-reinforced turbidimetry method. The levels of plasma endothelin were determined with RIA.The levels of plasma nitric oxide were determined with colorimetry. Fasudil group and the conventional therapy group admitted to hospital the next day fasting blood drawn 6mL Plasma levels of C-reactive protein, endothelin, nitric oxide level. And in clinical treatment of 2weeks after the retest those levels of control group, resting fasting state, blood plasma C-reactive protein, endothelin, nitric oxide level.ResultsThe levels of plasma nitric oxide decreased significantly and the levels of endothelin and C-reactive protein increased significantly in the patients of unstable angina pector compared to those in control group(P<0.01).There was no significant differences in the levels of plasma C-reactive protein, endothelin, nitric oxide between the fasudil therapeutic group and conventional therapeatic group(P>0.05)before the treatment.After fasudil therapy,the levels of nitric oxide increased significantly; the levels of plasma endothelin and C-reactive protein decreased significantly, compared with the pre-treatment there was a significant difference (P<0.01), With the conventional treatment group also compared the difference was significant(P<0.05). Fasudil hydrochloride group and the conventional treatment group after treatment, the clinical efficiency higher, reduce the number of angina attacks, duration shortened, the difference was statistically significant (P<0.05).ConclusionsFasudil has a great benefits to the patients with unstable angina pectoris with the possible benefits:1. Fasudil can decreased the level of inflammation signal, The inflammation of coronary atherosclerotic lesion in UAP can be blocked by Fasudil. Meantime, the drug stabilize the atherosclerosis plaque and decrease the risk of plaque rupture.2.Can improve endothelial function, slowing the process of coronary atherosclerosis.3. Can significantly reduce angina pectoris, reducing attack frequency, shorten the duration;4. Fasudil on the clinical effect of unstable angina pectoris may be related to anti-inflammation, improve endothelial function.However, as the sample size small, relatively short follow-up period, a large-scale clinical trials to be further confirmed.