Atorvastatin reduces proinflammatory markers in hypercholesterolemic patients

Background: Reduction in cardiovascular events with statins has been in part attributed to their anti-inflammatory properties. Objective: Evaluate the effects of atorvastatin on levels of inflammatory markers, such as tumor necrosis factor-alpha. (TNF), interleukins (IL-1 and IL-6), soluble intercellular adhesion molecule-1 (sICAM-1) and C-reactive protein (CRP) in hypercholesterolemic patients (LDL-cholesterol > 160 mg/dL). Methods and results: Two lipid-lowering regimens were taken for 8 weeks. One set of patients (n = 45, 26 men, average 50 2 years of age) was subjected to atorvastatin treatment (20-40 mg/day), plus diet recommendation. Another set of patients (n = 23, 12 men, average 53 3 years of age) went through diet recommendation alone. Both groups were recommended to perform standard physical activity. Plasma samples were collected after overnight fasting at baseline and after 8 weeks for ELISA. The use of atorvastatin when compared to diet alone, resulted in significant (P < 0.0001) reductions for: LDL-cholesterol (39.9% versus 4.4%), TNF (21.4% versus 2.9%), IL-6 (22.1% versus 2.0%), IL-1 (16.4% versus 2.7%) and sICAM-1 (9.6% versus 0.1 %), respectively. The percentage of patients with CRP levels >3 mg/dL in the atorvastatin group fell from 25.0 to 6.7% (P < 0.0001) while in the diet group the reduction was not significant. Conclusion: In hypercholesterolemic patients, atorvastatin, compared to diet alone resulted in significant reductions in levels of proinflammatory cytokines (TNF, IL-1 and IL-6) as well as in sICAM-1 and CRP. Thus, statin-induced inhibition of inflammatory markers may play an important role in the pharmacological and clinical effects of statins seen in cardiovascular diseases. (C) 2004 Elsevier Ireland Ltd. All rights reserved.