The influence of short-term treatment with simvastatin on the inflammatory profile of patients with hypercholesterolaemia

Background Treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors can reduce cardiovascular mortality of patients with atherosclerosis, This effect is probably due not only to a decrease in concentration of cholesterol, but also to non-lipid-involving mechanisms elicited by the action of statin drugs. Objective To investigate the influence of short-term therapy with simvastatin on markers of inflammation and oxidation processes in patients with hypercholesterolaemia, Design We administered 20 mg simvastatin daily for 12 weeks to 19 patients with hypercholesterolaemia (250-400 mg/dl) Peripheral blood samples for evaluation of plasma concentrations of thiobarbituric acid reactive substances (malonaldehyde), stable metabolites of nitric oxide (NOx) and interleukin 6 (IL-6) were taken before and after the therapy. Results Plasma levels of malonaldehyde decreased significantly (from 4.533 +/- 0.428 versus 3.690 +/- 0.310 mu mol/l, P = 0.04) during the study period. Similarly, there was a significant decrease in the plasma concentrations of NOx (from 33.477 +/- 4.352 mu mol/l versus 25.919 +/- 2.561 mu mol/l, P = 0.02). There were significant positive correlations between concentrations of total cholesterol and NOx in plasma (r = 0.4397, P = 0.008) and of low-density lipoprotein and NOx (r = 0.3987, P = 0.02). The plasma level of interleukin 6 remained unchanged by the intervention (1.837 +/- 0.200 versus 1.820 +/- 0.169 pg/ml, P = 0.54). Conclusions Short-term therapy with simvastatin decreases the plasma concentrations of markers of peroxidation of lipids and of stable metabolites of nitric oxide in hypercholesterolaemic patients, but leaves levels of interleukin 6 unaffected. Coron Artery Dis 12:143-148 (C) 2001 Lippincott Williams & Wilkins.