evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2019-1-54-64evrazkar-321Research ArticleОБЗОРREVIEWСТАТИНЫ ПРИ ОСТРОМ КОРОНАРНОМ СИНДРОМЕSTATINS IN ACUTE CORONARY SYNDROMESАлявиА. Л.AlyaviA. L.

Д.м.н., профессор, академик АН Республики Узбекистан;

Ташкент, Узбекистан

MD, Prof., Academician of the Academy of Sciences of the Republic of Uzbekistan

Tashkent, Uzbekistan

noemail@neicon.ruКенжаевС. Р.KenjaevS. R.

К.м.н., младший научний сотрудник

100107, Узбекистан, г. Ташкент, Чиланзарский район, Малая кольцевая дорога, дом 2

тел. +99878 1504600

PhD (med.), Junior research worker

100107, Uzbekistan, Tashkent, Chilanzar district, Small Ring Road, Building 2

phone: +998901753857

doctorsirojiddin@gmail.comАлимовД. А.AlimovD. A.

Д.м.н., главный научный сотрудник

Ташкент, Узбекистан

MD, Chief research worker

Tashkent, Uzbekistan

noemail@neicon.ruКенжаевМ. Л.KenjaevM. L.

Д.м.н., главный научный сотрудник

Ташкент, Узбекистан

MD, Chief research worker

Tashkent, Uzbekistan

noemail@neicon.ruРахимоваР. А.RakhimovaR. A.

К.м.н., старший научный сотрудник

Ташкент, Узбекистан

PhD (med.), Senior research worker

Tashkent, Uzbekistan

noemail@neicon.ruКойировА. К.KoyirovA. K.

К.м.н., докторант

Ташкент, Узбекистан

PhD (med.), Doctoral student

Tashkent, Uzbekistan

noemail@neicon.ruМирмаксудовМ.MirmaksudovM. S.

Резидент 1-го года обучения магистратуры

Ташкент, Узбекистан

Candidate of Master

Tashkent, Uzbekistan

noemail@neicon.ruРеспубликанский специализированный научнопрактический медицинский центр терапии и медицинской реабилитацииУзбекистанRepublican Specialized Scientific-and-Practical Medical Center of Therapy and Medical RehabilitationUzbekistanРеспубликанский научный центр экстренной медицинской помощиУзбекистанRepublican Scientific Center of Emergency Medical AidUzbekistanТашкентская медицинская академияУзбекистанTashkent Medical AcademyUzbekistan201930032019015464Copyright © Аляви А.Л., Кенжаев С.Р., Алимов Д.А., Кенжаев М.Л., Рахимова Р.А., Койиров А.К., Мирмаксудов М.S., 20192019Аляви А.Л., Кенжаев С.Р., Алимов Д.А., Кенжаев М.Л., Рахимова Р.А., Койиров А.К., Мирмаксудов М.Alyavi A.L., Kenjaev S.R., Alimov D.A., Kenjaev M.L., Rakhimova R.A., Koyirov A.K., Mirmaksudov M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/321

В статье обобщены результаты последних исследований (ARMYDA, NAPLES II, MIRACL, ARMYDA-ACS, JUPITER, LUNAR) с использованием в клинической практике ингибиторов гидрок-симетилглутарил-КоА-редуктазы (статинов) у больных с острым коронарным синдромом, в том числе у лиц, подвергшихся чрескожному коронарному вмешательству. Клиническими и экспериментальными исследованиями доказаны липидоснижающие, про тивовоспалительные и другие плейотропные эффекты статинов при острых формах ишемической болезни сердца. Авторами изучено также влияние статинов на оглушенный миокард, реперфузионное повреждение миокарда при остром инфаркте миокарда.

This review article provides results of recent studies (ARMYDA, NAPLES II, MIRACL, ARMYDA-ACS, JUPITER, LUNAR) with the use of inhibitors of HMG CoA reductase (statins) in patients with acute coronary syndrome and patients undergoing percutaneous coronary intervention. Based on the results of these clinical and experimental studies, lipid-lowering, anti-inflammatory and various other pleiotropic effects of statin therapy in acute forms of coronary heart disease have been proved. Also, the authors presented the main results and conclusions on the studies conducted in our center to study the effect of statins on the stunned myocardium, reperfusion injury of the myocardium in acute myocardial infarction.

статинплейотропный эффектострый коронарный синдромчрескожные коронарные вмешательстваstatinspleiotropic effectsacute coronary syndromepercutaneus coronary interventionsReferencesКурбанов Р.Д. Клинические протоколы диагностики и лечения сердечно-сосудистых заболеваний. Ташкент 2014.Kurbanov, R.D. Clinical protocols for diagnostics and treatmentof cardiovascular diseases. Tashkent, 2014. (in Russian)Alyavi A.L., Kenjaev S. et al. Influence of high dose atorvastatin on myocardial stunning in acute myocardial infarction. Atherosclerosis 2017; 263: e245.Alyavi A.L., Kenjaev S. et al. Influence of high dose atorvastatin on myocardial stunning in acute myocardial infarction. Atherosclerosis 2017; 263: e245.Atalar E., Coskun S., Haznedaroglu I.C. et al. Immediate effects of fluvastain on circulating soluble endothelial protein C and free tissue factor pathway inhibitor in acute coronary syndromes. Cardiovasc Drugs Ther 2005; 19 (3): 177-81.Atalar E., Coskun S., Haznedaroglu I.C. et al. Immediate effects of fluvastain on circulating soluble endothelial protein C and free tissue factor pathway inhibitor in acute coronary syndromes. Cardiovasc Drugs Ther 2005; 19 (3): 177-81.Baigent C., Keech A., Kearney P.M. et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366 (9493): 1267-78.Baigent C., Keech A., Kearney P.M. et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366 (9493): 1267-78.Briguori C., Visconti G., Focaccio A. et al. Novel approaches for preventing or limiting events (Naples) II trial: impact of a single high loading dose of atorvastatin on periprocedural myocardial infarction. J Amer Coll Cardiol 2009; 54 (23): 2157-63.Briguori C., Visconti G., Focaccio A. et al. Novel approaches for preventing or limiting events (Naples) II trial: impact of a single high loading dose of atorvastatin on periprocedural myocardial infarction. J Amer Coll Cardiol 2009; 54 (23): 2157-63.Cannon C.P., Braunwald E, McCabe C.H. et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. New Engl J Med 2004; 350 (15): 1495-504.Cannon C.P., Braunwald E, McCabe C.H. et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. New Engl J Med 2004; 350 (15): 1495-504.Cardiovascular diseases. WHO Fact sheet №317. Updated 2017 May.Cardiovascular diseases. WHO Fact sheet №317. Updated 2017 May.de Lemos J.A., Blazing M.A., Wiviott S.D. et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA 2004; 292 (11): 1307-16.de Lemos J.A., Blazing M.A., Wiviott S.D. et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA 2004; 292 (11): 1307-16.Pasceri V., Patti G., Nusca A. et al. ARMYDA Investigators. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of MYocardial Damage during Angioplasty) study... Circulation 2004; 110 (6): 674-8.Pasceri V., Patti G., Nusca A. et al. ARMYDA Investigators. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of MYocardial Damage during Angioplasty) study... Circulation 2004; 110 (6): 674-8.Di Sciascio G., Patti G., Pasceri V. et al. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: results of the ARMYDARECAPTURE (Atorvastatin for Reduction of Myocardial Damage During Angioplasty) Randomized Trial. J Amer Coll Cardiol 2009; 54 (6): 558-65.Di Sciascio G., Patti G., Pasceri V. et al. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: results of the ARMYDARECAPTURE (Atorvastatin for Reduction of Myocardial Damage During Angioplasty) Randomized Trial. J Amer Coll Cardiol 2009; 54 (6): 558-65.Glynn R.J., Danielson E., Fonseca F.A. et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. New Engl J Med 2009; 360 (18): 1851-61.Glynn R.J., Danielson E., Fonseca F.A. et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. New Engl J Med 2009; 360 (18): 1851-61.Ibanez B., James S., Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Europ Heart J 2018; 39 (2): 119-77.Ibanez B., James S., Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Europ Heart J 2018; 39 (2): 119-77Luzak B., Rywaniak J., Stanczyk L., Watala C. Pravastatin and simvastatin improves acetylsalicylic acid-mediated in vitro blood platelet inhibition. Europ J Clin Invest 2012; 42 (8): 864-72.Luzak B., Rywaniak J., Stanczyk L., Watala C. Pravastatin and simvastatin improves acetylsalicylic acid-mediated in vitro blood platelet inhibition. Europ J Clin Invest 2012; 42 (8): 864-72.Moscardo A., Valles J., Latorre A. et al. Reduction of platelet cytosolic phospholipase A2 activity by atorvastatin and simvastatin: biochemical regulatory mechanisms. Thromb Res 2013; 131 (4): e154-9.Moscardo A., Valles J., Latorre A. et al. Reduction of platelet cytosolic phospholipase A2 activity by atorvastatin and simvastatin: biochemical regulatory mechanisms. Thromb Res 2013; 131 (4): e154-9.Mozaffarian D., Benjamin E.J., Go A.S. et al. Heart disease and stroke statistics - 2016 update: a report from the American Heart Association. Circulation 2016; 133: e38-e60.Mozaffarian D., Benjamin E.J., Go A.S. et al. Heart disease and stroke statistics - 2016 update: a report from the American Heart Association. Circulation 2016; 133: e38-e60.O’Gara P.T., Kushner F.G,. Ascheim D.D. et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 127 (4): e362-425.O’Gara P.T., Kushner F.G,. Ascheim D.D. et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 127 (4): e362-425.Pasceri V., Patti G., Nusca A. et al. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of Myocardial Damage during Angioplasty) study. Circulation 2004; 110 (6): 674-8.Pasceri V., Patti G., Nusca A. et al. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of Myocardial Damage during Angioplasty) study. Circulation 2004; 110 (6): 674-8.Patti G., Cannon C.P., Murphy S.A. et al. Clinical benefit of statin pretreatment in patients undergoing percutaneous coronary intervention: a collaborative patient-level meta-analysis of 13 randomized studies. Circulation 2011; 123 (15): 1622-32.Patti G., Cannon C.P., Murphy S.A. et al. Clinical benefit of statin pretreatment in patients undergoing percutaneous coronary intervention: a collaborative patient-level meta-analysis of 13 randomized studies. Circulation 2011; 123 (15): 1622-32.Patti G., Pasceri V., Colonna G. et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes un dergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. J Amer Coll Cardiol 2007; 49 (12): 1272-8.Patti G., Pasceri V., Colonna G. et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes un dergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. J Amer Coll Cardiol 2007; 49 (12): 1272-8.Pitt B., Loscalzo J., Monyak J. et al. Comparison of LipidModifying Efficacy of Rosuvastatin Versus Atorvastatin in Patients With Acute Coronary Syndrome (from the LUNAR Study). Amer J Cardiol 2012; 109 (9): 1239-46.Pitt B., Loscalzo J., Monyak J. et al. Comparison of LipidModifying Efficacy of Rosuvastatin Versus Atorvastatin in Patients With Acute Coronary Syndrome (from the LUNAR Study). Amer J Cardiol 2012; 109 (9): 1239-46.Ray K.K., Cannon C.P. The potential relevance of the multiple lipidindependent (pleiotropic) effects of statins in the management ofacute coronary syndromes. J Amer Coll Cardiol 2005; 46 (8): 1425-33.Ray K.K., Cannon C.P. The potential relevance of the multiple lipidindependent (pleiotropic) effects of statins in the management ofacute coronary syndromes. J Amer Coll Cardiol 2005; 46 (8): 1425-33.Rezaie-Majd A., Prager G.W., Bucek R.A. et al. Simvastatin reduces the expression of adhesion molecules in circulating monocytes from hypercholesterolemic patients. Arterioscler Thromb Vasc Biol 2003; 23 (3): 397-403.Rezaie-Majd A., Prager G.W., Bucek R.A. et al. Simvastatin reduces the expression of adhesion molecules in circulating monocytes from hypercholesterolemic patients. Arterioscler Thromb Vasc Biol 2003; 23 (3): 397-403.Ridker P.M., Danielson E., Fonseca F.A. et al. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009; 373 (9670): 1175-82.Ridker P.M., Danielson E., Fonseca F.A. et al. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009; 373 (9670): 1175-82.Rodriguez A.L., Wojcik B.M., Wrobleski S.K. et al. Statins, inflammation and deep vein thrombosis: a systematic review. J Thromb Thrombolysis 2012; 33 (4): 371-82.Rodriguez A.L., Wojcik B.M., Wrobleski S.K. et al. Statins, inflammation and deep vein thrombosis: a systematic review. J Thromb Thrombolysis 2012; 33 (4): 371-82.Sanguigni V., Pignatelli P., Lenti L. et al. Short-term treatment with atorvastatin reduces platelet CD40 ligand and thrombin generation in hypercholesterolemic patients. Circulation 2005; 111 (4): 412-9.Sanguigni V., Pignatelli P., Lenti L. et al. Short-term treatment with atorvastatin reduces platelet CD40 ligand and thrombin generation in hypercholesterolemic patients. Circulation 2005; 111 (4): 412-9.Schwartz G.G., Olsson A.G., Ezekowitz M.D. et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285 (13): 1711-8.Schwartz G.G., Olsson A.G., Ezekowitz M.D. et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285 (13): 1711-8.Sposito A.C., Santos S.N., de Faria E.C. et al. Timing and dose of statin therapy define its impact on inflammatory and endothelial responses during myocardial infarction. Arterioscler Thromb Vasc Biol 2011; 31 (5): 1240-6.Sposito A.C., Santos S.N., de Faria E.C. et al. Timing and dose of statin therapy define its impact on inflammatory and endothelial responses during myocardial infarction. Arterioscler Thromb Vasc Biol 2011; 31 (5): 1240-6.Stefanadi E., Tousoulis D., Antoniades C. et al. Early initiation of low-dose atorvastatin treatment after an acute ST-elevated myocardial infarction, decreases inflammatory process and prevents endothelial injury and activation. Int J Cardiol 2009; 133 (2): 266-8.Stefanadi E., Tousoulis D., Antoniades C. et al. Early initiation of low-dose atorvastatin treatment after an acute ST-elevated myocardial infarction, decreases inflammatory process and prevents endothelial injury and activation. Int J Cardiol 2009; 133 (2): 266-8.Theroux P., Fuster V. Acute coronary syndromes: unstable angina and non-Q-wave myocardial infarction. Circulation 1998; 97 (12): 1195-206.Theroux P., Fuster V. Acute coronary syndromes: unstable angina and non-Q-wave myocardial infarction. Circulation 1998; 97 (12): 1195-206.Tousoulis D., Bosinakou E., Kotsopoulou M. et al. Effects of early administration of atorvastatin treatment on thrombotic process in normocholesterolemic patients with unstable angina. Int J Cardiol 2006; 106 (3): 333-7.Tousoulis D., Bosinakou E., Kotsopoulou M. et al. Effects of early administration of atorvastatin treatment on thrombotic process in normocholesterolemic patients with unstable angina. Int J Cardiol 2006; 106 (3): 333-7.Undas A., Celinska-Lowenhoff M., Brummel-Ziedins K.E. et al. Simvastatin given for 3 days can inhibit thrombin generation and activation of factor V and enhance factor Va inactivation in hypercholesterolemic patients. Arterioscler Thromb Vasc Biol 2005; 25 (7): 1524-5.Undas A., Celinska-Lowenhoff M., Brummel-Ziedins K.E. et al. Simvastatin given for 3 days can inhibit thrombin generation and activation of factor V and enhance factor Va inactivation in hypercholesterolemic patients. Arterioscler Thromb Vasc Biol 2005; 25 (7): 1524-5.Pignatelli P, Sanguigni V at al. Oxidative stress-mediated platelet CD40 ligand upregulation in patients with hypercholesterolemia: effect of atorvastatin. Journal of thrombosis and hemostasis. Vol 5, Iss 6. 2007 P.1170-1178Pignatelli P, Sanguigni V at al. Oxidative stress-mediated platelet CD40 ligand upregulation in patients with hypercholesterolemia: effect of atorvastatin. Journal of thrombosis and hemostasis. Vol 5, Iss 6. 2007 P.1170-1178

The authors declare that there are no conflicts of interest present.