INFLUENCE OF ROSUVASTATIN ON VASCULAR ENDOTHELIUM FUNCTIONAL STATE AND SYSTEMIC INFLAMMATION IN PATIENTS WITH ISCHEMIC HEART DISEASE AND DIABETES MELLITUS

Authors

  • I. M. Fushtey State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine» Zaporizhzhia, Ukraine, Ukraine
  • S. L. Podsevahina State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine» Zaporizhzhia, Ukraine, Ukraine
  • O. I. Palamarchuk State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine» Zaporizhzhia, Ukraine, Ukraine
  • O. V. Tkachenko State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine» Zaporizhzhia, Ukraine, Ukraine
  • I. A. Kulinich State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine» Zaporizhzhia, Ukraine, Ukraine

DOI:

https://doi.org/10.34287/MMT.4(55).2022.1

Abstract

Purpose of the study. The goal of the present study was to evaluate the effect of low dosed statins (rosuvastatin 10 mg/day) on the state of lipid and carbohydrate metabolism, insulin levels, vascular endothelial function, and markers of systemic inflammation in patients with ischemic heart disease in combination with diabetes mellitus.

Materials and research methods. We examined 83 patients with ischemic heart disease and type 2 diabetes mellitus aged 44 to 78 years (mean age was (56,8 ± 3,4) years). For all patients, the fasting glucose level was determined, the HOMA index, the levels of total cholesterol, low density lipoproteins, very low density lipoproteins, high density lipoproteins and triglycerides in the blood, the concentration of C-reactive protein, and the content of pro-inflammatory cytokines in the blood serum were calculated. To study the function of the endothelium, dopplerography of the brachial artery was used according to the D.S. Celermajer. All patients received IHD therapy according to generally accepted standards. The drugs were used against the background of stable oral hypoglycemic therapy. As cholesterol-lowering therapy, rosuvastatin was prescribed at a dose of 10 mg/day for 3 months.

Results. During the study, it was noted that in patients with coronary artery disease in combination with type 2 diabetes mellitus on the background of hyperand dyslipidemia, elevated levels of insulin and glucose, dysfunction of the vascular endothelium was revealed. Vascular endothelial dysfunction had a close correlation with markers of systemic inflammation, which was exacerbated by the presence of insulin resistance. While taking rosuvastatin at a dose of 10 mg/day, in addition to a sufficient lipid-correcting effect, there was a decrease in the level of IR, activity of systemic inflammation and improvement in the function of the vascular endothelium, which ensures the correction of additional risk factors in patients with coronary artery disease in combination with type 2 diabetes.

Conclusions. In patients with ischemic heart disease in combination with type 2 diabetes mellitus on the background of hyperand dyslipidemia, elevated levels of insulin and glucose, dysfunction of the vascular endothelium was revealed. Dysfunction of the vascular endothelium is closely correlated with markers of systemic inflammation, which is exacerbated by the presence of insulin resistance. Against the background of taking rosuvastatin at a dose of 10 mg/day, in addition to a sufficient lipid-correcting effect, a decrease in the level of IR, activity of systemic inflammation and an improvement in the function of the vascular endothelium were noted, which ensures the correction of additional risk factors in patients with coronary artery disease in combination with type 2 diabetes.

References

Abesadze GG, Alugishvili MZ, Loxovinina NL, Titenkov IV, Korzhenevskaya KV, Nil`k RY, et al. ROZUVASTATIN I EZETIMIB U BOLNYX ISHEMICHESKOJ BOLEZNYU SERDCZA POSLE KORONARNOGO SHUNTIROVANIYA. Arterial`naya gipertenziya [Internet]. 2014;20(6):591-599. Available from: doi: https://doi.org/10.18705/1607-419X-2014-20-6-591-599.

Puzik SG. Endothelial dysfunction in the pathogenesis of arterial hypertension and the progression of atherosclerosis. Family Medicine [Internet]. 2018;0(2):69-74. Available from: doi:10.30841/2307-5112.2.2018.145561.

Kumar A, Patel DR, Wolski KE, Lincoff AM, Kashyap SR, Ruotolo G, et al. Baseline fasting plasma insulin levels predict risk for major adverse cardiovascular events among patients with diabetes and high-risk vascular disease: Insights from the ACCELERATE trial. Diabetes and Vascular Disease Research [Internet]. 2019;16(2):171-177. Available from: doi:10.1177/1479164119827604.

Artime E, Romera I, Díaz-Cerezo S, Delgado E. Epidemiology and Economic Burden of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in Spain: A Systematic Review. Diabetes Therapy [Internet]. 2021;12(6):1631-1659. Available from: doi:10.1007/s13300-021-01060-8.

Blazing MA, Giugliano RP, Cannon CP, Musliner TA, Tershakovec AM, White JA, et al. Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18,144 patients after acute coronary syndromes: Final baseline characteristics of the IMPROVE-IT study population. American Heart Journal [Internet]. 2014;168(2):205-212.e1. Available from: doi:10.1016/j.ahj.2014.05.004.

Janus A, Szahidewicz-Krupska E, Mazur G, Doroszko A. Insulin Resistance and Endothelial Dysfunction Constitute a Common Therapeutic Target in Cardiometabolic Disorders. Mediators of Inflammation [Internet]. 2016;2016:1-10. Available from: doi:10.1155/2016/3634948.

Matsuzawa Y, Lerman A. Endothelial dysfunction and coronary artery disease. Coronary Artery Disease [Internet]. 2014;25(8):713-724. Available from: doi:10.1097/mca.0000000000000178.

Oesterle A, Laufs U, Liao JK. Pleiotropic Effects of Statins on the Cardiovascular System. Circulation Research [Internet]. 2017;120(1):229-243. Available from: doi:10.1161/circresaha.116.308537.

Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovascular Diabetology [Internet]. 2018;17(1). Available from: doi:10.1186/s12933-018-0762-4.

Roth G, Mensah G, Johnson C, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019.J Am Coll Cardiol.2020 Dec, 76 (25) 2982–3021.https://doi.org/10.1016/j.jacc.2020.11.010

Satoh M, Takahashi Y, Tabuchi T, Minami Y, Tamada M, Takahashi K, et al. Cellular and molecular mechanisms of statins: an update on pleiotropic effects. Clinical Science [Internet]. 2015;129(2):93-105. Available from: doi:10.1042/cs20150027.

Shulman GI. Ectopic Fat in Insulin Resistance, Dyslipidemia, and Cardiometabolic Disease. New England Journal of Medicine [Internet]. 2014;371(12):1131-1141. Available from: doi:10.1056/nejmra1011035.

Stone NJ, Robinson JG, Lichtenstein AH, Bairey NM, Blum CB, Eckel RH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Circulation [Internet]. 2014;129(25_suppl_2). Available from: doi:10.1161/01.cir.0000437738.63853.7a.

Cicha I, Urschel K. TNF-α in the cardiovascular system: from physiology to therapy. International Journal of Interferon, Cytokine and Mediator Research [Internet]. 2015:9. Available from: doi:10.2147/ijicmr.s64894.

Downloads

Published

2022-12-30

How to Cite

Fushtey, I. M. ., Podsevahina, S. L. ., Palamarchuk, O. I. ., Tkachenko, O. V. ., & Kulinich, I. A. . (2022). INFLUENCE OF ROSUVASTATIN ON VASCULAR ENDOTHELIUM FUNCTIONAL STATE AND SYSTEMIC INFLAMMATION IN PATIENTS WITH ISCHEMIC HEART DISEASE AND DIABETES MELLITUS. Modern Medical Technology, (4), 4–8. https://doi.org/10.34287/MMT.4(55).2022.1

Issue

Section

Original research