Place of atorvastatin in chronic obstructive pulmonary disease patients with no cardiovascular pathology


DOI: https://dx.doi.org/10.18565/therapy.2018.5.74-82

S.A. Smakotina, S.A. Berns, A.A. Golikova, A.S. Berns, E.B. Gerasimova

1 FSBEI of Higher Education «Kemerovo state medical university», Kemerovo, Russia; 2 FSBEI of Higher Education «A.I. Evdokimov Moscow state university of medicine and dentistry» of the Ministry of Healthcare of Russia, Moscow, Russia; 3 Autonomous public health care institution «Belyaev Kemerovo regional clinical hospital», Kemerovo, Russia
Due to pleiotropic effects of statins, the spectrum of their therapeutic possibilities increases in multiple way. Theoretical data of the effect of statins on systemic inflammation and endothelial function make it possible to study the effects of their action at ventilation disorders in chronic obstructive pulmonary disease (COPD). Aim of the study. To study the effect of 6-month atorvastatin treatment at the lipid spectrum, the severity of subclinical inflammation, pulmonary respiratory function and endothelial function in patients with COPD and without cardiovascular diseases. Material and methods. Smoking men with COPD of the 2 nd stage (n = 83) on the phone of stable baseline bronchodilator therapy with no clinical manifestations of cardiovascular diseases, initially and after 6 months of treatment, were tested for respiratory function and diffusivity of the lungs, also for reactive hyperemia of the brachial artery. Also lipid profile, the concentration of interleukin-6 (IL) -6, IL-8, tumor necrosis factor α (TNF-α) and endothelin-1 (ET-1) in blood serum and cardiovascular risk were calculated on the SCORE scale. Results. After 6 months of observation, target cholesterol levels of low-density lipoprotein (LDL-C) cholesterol were achieved in all patients treated with atorvastatin at a dose of 20 mg, with a significant decrease in the cardiovascular risk score on the SCORE scale, a significant positive dynamics of volumes and diffusivity of the lungs according to the results of bodipletizmography, a significant increase in the volume of forced expiration in one second (FEV1); increased endothelium-dependent dilatation; a decrease in plasma concentrations of ET-1 and pro-inflammatory cytokines. Conclusions. In patients with II stage of COPD without cardiovascular disease, 6-month therapy with atorvastatin helps to improve lipidogram indexes, decrease the concentration of proinflammatory cytokines; it improves lung respiratory function parameters and parameters reflecting endothelial dysfunction.
Keywords: chronic obstructive pulmonary disease, pleiotropic effects of statins, endothelial function, lipidogram, interleukins, pulmonary respiratory function
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    • About the Autors

    Svetlana A. Smakotina, MD, professor of the Department of intermediate level therapy, endocrinology and occupational disesses of FSBEI of Higher Education «Kemerovo state medical university» of the Ministry of Healthcare of Russia. E-mail: smak67@mail.ru.
    Svetlana A. Berns, MD, professor of the general medicine Department of the faculty of dentistry of FSBEI of Higher Education «A.I. Evdokimov Moscow state university of medicine and dentistry». Тel.: 8(916) 929-08-92; +7 (499) 726-54-24. E-mail: svberns@yandex.ru.
    Anna A. Golikova, MD, professor of the general medicine Department of the faculty of dentistry of FSBEI of Higher Education «A.I. Evdokimov Moscow state university of medicine and dentistry». E-mail: 414-05-17@mail.ru.
    Angelina S. Berns, laboratory assistant of the Department of internal medicine of the faculty of dentistry of FSBEI of Higher Education «A.I. Evdokimov Moscow state university of medicine and dentistry». E-mail: 89099172603@mail.ru.
    Evgenia B. Gerasimova, PhD, doctor of autonomous public health care institution «Belyaev Kemerovo regional clinical hospital».

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