Застосування розувастатину та альфа-ліпоєвої кислоти у хворих на нестабільну стенокардію

Цель: оценить влияние резвератрола по сравнению с розувастатином и их комбинации на липидный спектр у больных с гипертонической болезнью и дислипидемией.Материал и методы. В исследовании приняли участие 73 пациента, которые были распределены на две группы: I группа (n = 38) в начале исследования получала розувастатин в дозе 20 мг/сут в течение месяца, затем к терапии добавляли резвератрол в дозе 50 мг/сут еще месяц; II группа (n = 35) в начале исследования получала резвератрол в дозе 50 мг/сут один месяц, затем к терапии добавляли розувастатин в дозе 20 мг/сут. В начале и через 2 месяца исследования оценивали данные лабораторных исследований: уровень ОХС, ХС ЛПВП, ХС ЛПНП, ТГ; измеряли офисное артериальное давление (АД), частоту сердечных сокращений, проводили суточное мониторирование АД.Результаты. В конце наблюдения мы отметили общее снижение уровня ОХС в первой группе на 28,8 %, степень снижения (Δ) составила –1,7 ммоль/л, во второй группе уровень ОХС снизился на 32,4 %, (Δ = –2,2 ммоль/л). Пациенты, которые принимали в группах резвератрол, независимо от стадии лечения показывали лучшее снижение уровня ОХС. Снижение уровня ОХС наблюдалось как в первой, так и во второй группе, причем добавление второго препарата потенцировало холестеринснижающий эффект лечения. К концу периода наблюдения мы отметили достоверное снижение уровня ХС ЛПНП у пациентов обеих групп (p = 0,005/0,005): в первой группе на 27 % (Δ = –1 ммоль/л) против 25 % (Δ = –0,9 ммоль/л) во второй группе, различия недостоверны. Снижение уровня ХС ЛПНП было наиболее выражено у пациентов первой группы. Наиболее благоприятный эффект на уровень ХС ЛПВП мы отметили во второй группе: уровень ХС ЛПВП увеличился на 35,7 % (Δ = +0,5 ммоль/л) у этих пациентов, однако этот эффект был достигнут в результате значимого их увеличения после второго месяца лечения при дополнительном приеме розувастатина. Как в первой, так и во второй группе мы отметили достоверно значимое снижение ТГ, однако более выраженное снижение было в первой группе после добавления резвератрола к терапии. Следует отметить, что при меньшей степени снижения уровня ТГ (Δ –0,4/–0,2 ммоль/л в группах) и при меньшем количестве пациентов с ТГ выше 1,7 ммоль/л во второй группе мы отмечаем наибольшее уменьшение количества пациентов и степени снижения ТГ в процентном отношении. Мы выделили подгруппы пациентов Т (резвератрол), у которых уровень ТГ был выше 1,7 ммоль/л. В конце периода наблюдения уровень ТГ снизился до 1,6 ± 0,1 ммоль/л, степень снижения — –1,2 ммоль/л, в процентном отношении — 42,9 %, а количество пациентов уменьшилось до 3 человек.Выводы. Терапия резвератролом в сочетании с розувастатином приводила к нормализации липидного спектра крови у больных ГБ с дислипидемией. Резвератрол потенцировал холестеринснижающий эффект статина. Резвератрол достоверно снижал уровень триглицеридов в крови, особенно при исходно повышенном их уровне. Терапия резвератролом была безопасной, хорошо переносилась, побочные реакции не были зафиксированы у пациентов на протяжении всего периода наблюдения.

Hydroxychloroquine has been suggested to exert lipid lowering effects. The purpose of this study was to determine the effect of hydroxychloroquine on total cholesterol and on other lipoproteins in a controlled trial involving patients with systemic lupus erythematosus (SLE). Seventeen female patients with SLE were enrolled in a double-blind, randomized, placebo-controlled, multiple-dose pilot study comparing placebo with hydroxychloroquine at daily doses of 400 and 800 mg. The primary endpoint was alteration in total cholesterol. Patients were evaluated at two screening visits pretreatment and at three monthly follow-up visits. At all visits, a fasting panel of lipoproteins, disease activity, and adverse drug effects were assessed. There were no significant alterations in lipoproteins in patients receiving placebo. Treatment with 400 mg/day of hydroxychloroquine resulted in a significant decrease in total cholesterol (mean decrease of 11.6 mg/dL). Treatment with 800 mg/day of hydroxychloroquine resulted in a significant decreases in total cholesterol (mean decrease of 13.4 mg/dL), triglycerides, very low density lipoproteins, cholesterol, and the ratios of total cholesterol/high density lipoprotein cholesterol and low density lipoprotein/high density lipoprotein cholesterol. More adverse effects were noted among patients receiving the high dose (800 mg/day). Hydroxychloroquine affects a significant reduction in total cholesterol in patients with SLE. The findings of this double-blind, placebo-controlled, pilot trial support the conclusions of earlier open trials. This lipid-lowering effect may be an added benefit of hydroxychloroquine treatment in these patients with a high prevalence of atherosclerotic cardiovascular disease.

The objective of this study is to determine the relationships between plasma atorvastatin concentrations, LDL (low-density lipoprotein) cholesterol reduction, and atorvastatin dose; the earliest time at which lipid levels change when atorvastatin treatment is initiated or discontinued; and alterations in LDL particle composition. Twenty-four subjects with elevated LDL-cholesterol were treated with escalating daily doses of 5, 20, and 80 mg atorvastatin for 6 weeks each. Serial plasma lipid and lipoprotein analyses were performed during the initiation and discontinuation of atorvastatin therapy, as well as at steady state. LDL-apolipoprotein B and LDL-cholesterol were measured directly after ultracentrifugation, and LDL-cholesterol also was estimated by the method of Friedewald. Steady-state atorvastatin pharmacokinetic parameters were estimated on the last day of each dosing period. LDL-cholesterol (Friedewald) reductions of 34%, 43%, and 57% were produced by atorvastatin doses of 5, 20, and 80 mg, respectively. The mean dose-response relationship was log linear, and almost all individual dose-response curves paralleled the mean curve. LDL-apolipoprotein B reductions were slightly less than those of LDL-cholesterol. Atorvastatin area under the curve (AUC(0-24) values increased proportionally with dose, while values of Cmax (maximum concentration) increased more than proportionally, and Cmin (minimum concentration) increased less than proportionally. Following initiation of dosing, statistically significant decreases in total cholesterol, LDL-cholesterol (beta quant), and LDL-apolipoprotein B were observed within 24 hours and in LDL-C (Friedewald) within 72 hours. Following discontinuation of drug dosing, statistically significant increases were observed in total cholesterol and LDL-cholesterol (Friedewald) within 48 hours and in LDL-cholesterol (beta quant) and LDL-apolipoprotein B within 72 hours. At each dose, an individual's LDL-cholesterol response was not correlated with AUC(0-24). In conclusion, atorvastatin produces marked LDL-cholesterol reductions, the mean dose-response relationship is log linear, almost all individual dose-response curves parallel the mean dose-response curve, onset and cessation of action are rapid, the estimated and measured LDL-cholesterol are the same, LDL-cholesterol and LDL-Apo B reductions are similar, and plasma concentrations are not correlated with LDL-cholesterol reduction at a given dose.

Objective: This study was conducted to investigate the relationship between serum lipid profile and breast cancer disease.Patients and methods: One hundred breast cancer women and 75 women with benign breast mass as a control group were included in the study. The control and the patient groups were aged matched. The age range of the control group was between 25 to 70 years (mean ± SD: 50.4 ± 15.1 years). The age range of the patient group was between 25 to 71 yeas (mean ± SD: 49.1 ± 14.6 years). The patients were undergone radical modified mastectomy, then treated with chemotherapy and radiotherapy after the operation. Five mL of blood samples from the patient and control groups were taken, and the patient samples were taken before the operation. The blood samples were analyzed for serum lipid profile. The patients and the control groups were advised to fast for 14 hours before taking the blood samples. Body mass index was measured for the patients and controls. The stage, lymph involvement, and metastasis of the cancer were also included.Results: Body mass index (BMI) in patients was significantly higher than controls. However, serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C) and atherogenic index (AI), in the patients were significantly lower than controls. High-density lipoprotein cholesterol (HLD-C) was higher in the patients compared with the controls but not significant.Conclusion: a significant decrease in TC, TGs, and LDL-C with no significant increase for HDL-C was noticed in breast cancer women. Serum lipid profile may not be considered as a risk factor for breast cancer.

An open-label, uncontrolled, prospective study of the effects of atorvastatin 10 mg on low-density lipoprotein cholesterol levels in chinese adults with coronary artery disease and hypercholesterolemia

Association of lower total bilirubin level with statin usage: The United States National Health and Nutrition Examination Survey 1999–2008

This systematic review aimed to gather data on the effects of sumac supplementation on lipid profile. A systematic literature search was carried out using electronic databases (PubMed, Scopus, and Web of Science) up to March 2023 to identify eligible randomized controlled trials (RCTs) assessing the effects of sumac intake on lipid profile as an outcome. All participants enrolled in our study were adult individuals who consumed sumac, in various forms, as an intervention. The included articles were assessed using the Cochrane risk of bias assessment tool. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95% confidence interval. In total, seven RCTs with a total sample size of 570 subjects were included. This study found a significant decrease in total cholesterol (TC) (weighted mean difference [WMD]: -10.01 mg/dL; 95% CI: -18.67, -1.34), triglyceride (TG) (WMD: -8.52 mg/dL; 95% CI: -14.79, -2.25), and low-density lipoprotein (LDL)-C levels (WMD: -9.25 mg/dL; 95% CI: -14.56, -3.93); Moreover, a significant increase was observed in high-density lipoprotein (HDL)-C concentration (WMD: 2.97 mg/dL; 95% CI: 0.75, 5.19). The reduction in TG and TC was greater in studies with a duration of ≥12 compared to <12 weeks. The increase in HDL-C was greater in participants with an intervention duration of ≥12 compared to <12 weeks. Moreover, subgroup analysis based on the dose of sumac suggested a significant reduction in TC and LDL, specifically for doses below 3 g. Consumption of sumac significantly decreased serum TC, LDL-C, and TG concentrations. This study suggested significantly positive effects on HDL-C by intake of sumac. Longer interventions (>12 weeks) have a more favorable impact on TC, LDL-C, and HDL-C, while sumac doses below 3 g/day show greater effects on TC and LDL-C. These findings underscore the potential of sumac supplementation as a valuable approach to lipid profile management.

VI. Drug Therapy

Objectives: The objective of the study was to evaluate the effects of plant stanol esters and bran fiber on lipids, stool weight and stool frequency in preschool children.Methods: The present study was a 13 week open cross-over study designed to evaluate the effects of plant stanol ester in healthy two to five year old preschool children. After a one week lead-in, eligible children were randomly assigned to begin with either Diet Phase A (plant stanol ester) or Phase B (wheat bran fiber). Each diet phase was four weeks long, followed by a two-week wash-out, and then cross-over to the alternate diet. During Diet Phase A children consumed three eight-gram servings of a spread, each containing one gram of plant stanols, for total daily dose of three grams. During Diet Phase B, children added five grams of dietary fiber to their diet for the first two weeks and then ten grams for the second two weeks.Results: Overall, for the whole study group, plant-stanol-ester spread use yielded a decrease in total cholesterol of 19.9 mg/dL (12.4% reduction from baseline) and a 14.6 mg/dL decrease in LDL cholesterol (15.5% reduction from baseline). There were no significant changes in HDL-cholesterol or triglyceride levels. A predominately insoluble dietary fiber supplement derived from wheat bran, as expected, yielded a small but non-significant decrease in total cholesterol of 6.1 mg/dL, a four percent reduction from baseline.Conclusions: Results demonstrated that preschool age children could adhere to a program requiring consumption of three daily servings of spread containing plant stanol ester and that this level of consumption resulted in a significant decrease in total cholesterol and LDL cholesterol after a four week period. In addition, consumption of plant stanol ester was not associated with any short-term adverse health effects.

Statins are used to lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels among patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). However, there are no studies of statin efficacy among T1DM patients. T1DM patients have higher gut cholesterol absorption than synthesis; hence cholesterol absorption inhibitors such as ezetimibe may also be effective in T1DM. Here, we compare the effects of simvastatin and ezetimibe among subjects with T1DM and T2DM. Subjects with T1DM (n=20, 45% female) or T2DM (n=27, 56% female) were assigned to alternating therapy with simvastatin (40 mg) or ezetimibe (10 mg) for 6 weeks in a crossover design. Among T2DM subjects, simvastatin lowered TC and LDL-C from the baseline (-25±4% and -40±5%, respectively, P<0.001), whereas ezetimibe was not as effective (-2±4% and -3±5%, respectively). Among T1DM subjects, both statin and ezetimibe showed significant decreases in TC and LDL-C from baseline, although ezetimibe lowered LDL-C much more than simvastatin (-32±12 (P<0.001) and -19±5% (P<0.01), respectively). Effect of simvastatin on LDL-C was much lower among T1DM subjects compared to T2DM subjects (P=0.02). This study shows that the cholesterol synthesis inhibitor simvastatin was less effective in lowering LDL-C in T1DM than T2DM subjects, whereas the cholesterol absorption inhibitor ezetimibe was at least as effective in lowering LDL-C as simvastatin among T1DM subjects.

The increased worldwide interest in performing coronary artery bypass grafting operations on a beating heart has made the question of the results of these operations in patients with low contractility of the left ventricular myocardium belonging to the high-risk category urgent. The aim of our study was a comparative assessment of the immediate results of surgical treatment of patients with reduced (LVEF &lt;45%) and normal myocardial contractility, operated under MIRM conditions. Materials and methods. A comparative analysis of the immediate results of surgical treatment of 302 patients with coronary artery disease who underwent beating heart bypass surgery was carried out. Most of the patients were men (81.3%). The average age of the general group was 59.2 ± 7.4 years. The patients were divided into two groups - patients with LVEF less than 45% - 49 patients (16%) and patients with LVEF more than 45% - 253 people (84%). Results. Despite the fact that for a number of clinical indicators (concomitant diseases), we obtained a statistically significant difference - arterial hypertension, BCA lesion, mean LVEF, according to the main hemodynamic criteria, such as - unstable angina pectoris, middle class according to CCS and NYHA, the number of women in group, lesion of the trunk of the LCA and multivessel coronary artery disease, we did not reveal statistically significant differences between our groups. Nevertheless, the initial degree of operational risk according to EuroSCORE II was significantly higher in the first group of patients - with a low left ventricular ejection fraction. Conclusions. Our results of a comparative assessment of two groups of patients - with reduced LV ejection fraction (less than 45%) and with normal contractile ability, who underwent minimally invasive myocardial revascularization, showed the high efficiency of this type of surgical treatment.

Obesity is a worldwide epidemic and there are many diseases associated with it. Recent studies suggested that melatonin may be involved in the regulation of body mass and metabolic homeostasis through different mechanisms.To this purpose, we conducted an experimental study on 24 adults male Wistar rats, separated into 2 control groups and 1 test group. Our experimental protocol took place in three phases, an obesity induction phase in which the rats were subjected to a hyper fat diet “Cafeteria diet”. A therapeutic phase in which the control group received NaCl as a placebo, the test group was treated with melatonin at a dose of 5mg/kg/day. The groups were randomized and received treatment intraperitoneally for 6 weeks. A Biological blinded evaluation for lipidic, glucidic, and inflammatory (CRP) assessments were performed for each group.The results of our study showed that the Cafeteria diet significantly increased body weight with a gain of up to 126g (p=0.00). The biological analysis of the blood of rats treated with melatonin showed a decrease in blood glucose levels, triglycerides, LDL, HDL, CRP and total cholesterol compared to the initial values. Plasma analysis results obtained at the end of the therapeutic phase between melatonin and placebo‐treated rats showed a significant decrease in total cholesterol (p=0.002), LDL (p=0.005), HDL (p=0.014) and blood glucose (p=0.013). The difference between the two groups for CRP (p=0.084) and triglycerides (p=0.116) was not significant.Based on our results melatonin seems to have a beneficial effect against metabolic disorders related to obesity.Support or Funding InformationN/A

Statins do not always decrease coronary heart disease mortality, which was speculated based on increased serum plant sterols observed during statin treatment. To evaluate plant sterol atherogenicity, we fed low density lipoprotein-receptor deficient (LDLr(+/-)) mice for 35 weeks with Western diets (control) alone or enriched with atorvastatin or atorvastatin plus plant sterols or stanols. Atorvastatin decreased serum cholesterol by 22% and lesion area by 57%. Adding plant sterols or stanols to atorvastatin decreased serum cholesterol by 39% and 41%. Cholesterol-standardized serum plant sterol concentrations increased by 4- to 11-fold during sterol plus atorvastatin treatment versus stanol plus atorvastatin treatment. However, lesion size decreased similarly in the sterol plus atorvastatin (-99% vs. control) and the stanol plus atorvastatin (-98%) groups, with comparable serum cholesterol levels, suggesting that increased plant sterol concentrations are not atherogenic. Our second study confirms this conclusion. Compared with lesions after a 33 week atherogenic period, lesion size further increased in controls (+97%) during 12 more weeks on the diet, whereas 12 weeks with the addition of plant sterols or stanols decreased lesion size (66% and 64%). These findings indicate that in LDLr(+/-) mice 1) increased cholesterol-standardized serum plant sterol concentrations are not atherogenic, 2) adding plant sterols/stanols to atorvastatin further inhibits lesion formation, and 3) plant sterols/stanols inhibit the progression or even induce the regression of existing lesions.

The effects of fresh zucchini on nutritional status, and biological indicators for the prevention of cardiovascular disease in rats fed high-fat diets investigated in this study. Thirty Sprague Dawley rats were randomly divided into two main groups the first, negative control group Co (-) (n = 6), fed basal diet, The second group (n = 24) fed high-fat diet (containing basal diet + 5% tallow + 1% cholesterol + 0.02% bile salt). This group was divided into four subgroups each group 6 rats: group positive control co (+) fed high-fat diet only, group 1 (G (1)) fed high-fat diet plus 10% zucchini, group 2 (G (2) fed high-fat diet plus 15% zucchini and group 3 (G (3)) fed high-fat diet plus 20% zucchini. The levels of serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured after eight wk. of experimental treatment. The pathologic changes of the heart, spleen and kidney were evaluated. SPSS, one way ANOVA was used to analyze the results. The results indicated that the mean values of body weight gain (BWG) and feed efficiency ratio (FIR) in G (2) and G (3) showed significant decrease compared to co (-), co (+) and G 1. The results showed that in groups (G1, G2 and G3) the relative weight of heart had significant increase when compared with control negative group. But liver and spleen weight had no significant difference when compared with control negative and positive group, the levels of TC, TG and LDL-C were significantly increased in co (+) (P %, 15% and 20%) had significant decrease in TC and LDL-C compared with co (+), also G2 and G3 had improve significant in HDL-C when compared with co. (+). The groups fed on zucchini give results similar to group co. (-). The best treatment was zucchini (15% and 20%) which had lowest values of total lipid cholesterol and LDL-C, and the best values of HDL-C, HDL-C/TC % for all groups fed on high fat diet and zucchini increased non significantly (p ≤ 0.05) the HDL-C/TC % index compared to group co. (+). while, G2 and G3 gave significant decrease in LDL-C/HDL-C ratio compared to group co. (+). Morphologic changes of heart, spleen and kidney revealed that groups G2 and G3 had a similar preventive effect against CHD in this experimental model. In conclusion, results showed that zucchini had similar potential to attenuate CHD-related parameters in a mild oxidative stress induced by high-fat diet in rats.

Research indicates that bitter melon could be useful in the management of dyslipidemia. Still, there is disagreement concerning the findings. This systematic study was undertaken to clarify the impact of consuming bitter melon on lipid profile. The databases Web of Science, Cochrane Library, PubMed, and Scopus were queried from inception until February 9, 2023. The study assessed triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. The effect sizes were calculated using weighted mean differences (WMDs) and 95% confidence intervals (CIs). Eight randomized controlled trials (RCTs) with a total of 423 participants were included. Bitter melon consumption resulted in a significant decrease in plasma concentrations of TC (WMD; -9.71 mg/dL; CI: -17.69 to -1.74, p = 0.01) and TG (WMD; -10.24 mg/dL; CI: -19.92 to -0.56, p = 0.03), while bitter melon did not significantly lower blood LDL-C (WMD; -8.66 mg/dL; CI: -19.83 to 2.50, p = 0.12) and HDL-C concentrations (WMD; 0.54 mg/dL; CI: -2.38 to 3.45, p = 0.71). Subgroup analysis showed a significant decrease in TC and LDL-C and an increase in HDL-C at a dose of ≤ 2000 mg/day and an intervention period of ≤ 8 weeks. Also, the greatest impact of LDL-C and HDL-C was seen in diabetic and prediabetic people. Bitter melon supplementation positively impacts TC and TG levels. The limitations of this study were short-term trials (less than 3 months).