Vascular inflammation markers and effects ofstatins in risky acute coronary syndromes

Coronary artery disease is an important cause of morbidity and mortality in adult patient population around the world. Coronary artery disease can be seen in different clinical presentations. In most conditions, acute coronary syndromes are seen following atherosclerotic plaque rupture or erosion. In acute coronary syndrome patients vascular inflammation biomarkers are also elevated besides cardiac biomarkers showing myocardial damage like cardiac troponins. Forty patients admitted to our emergency department with non-ST segment elevation acute coronary syndome were enrolled in our study. All of the patients undergone coronary angiography because all of these patients had intermediate or high risk unstable angına pectoris or non-ST segment elevation myocardial infarction. Mean age of patients was 65.1±13.8 (p=0.642). 19 patients were women and 21 patients were men (%47,5 vs. %52,5). Serum sample for hs-CRP and sLOX-1 receptor was taken at arrival time and 72nd hour control. Modified Gensini score which gives information about atherosclerotic plaque burden was calculated in all patients. Patients were randomized to two identical groups and Atorvastatin and Rosuvastatin were given to groups. We took blood samples at presentation and at 72nd hour controls for hs-CRP and sLOX-1 receptor. Primary endpoint was difference between 2 statins on vascular inflammation biomarkers in acute coronary syndrome patients. Secondary end-point was the relation of atherosclerotic plaque burden with vascular inflammation biomarkers. Modified Gensini score was associated with higher values of hs-CRP and sLOX-1 receptor. We found higher modified Gensini scores in higher hs-CRP and sLOX-1 receptor levels (p values<0.01). According to Spearman rank correlation test, there was a positive correlation between modified Gensini scores and hs-CRP and sLOX-1 receptor levels (r=0.423, p<0.01 and r=0.653, p<0.01). We did not find significant difference in hs-CRP values at 72nd hour control in two different statin groups (p values 0.888 and 0.079). Also we did not find significant difference in sLOX-1 receptor values at 72nd hour control in two different statin gropus (p values 0.681 and 0.296). vi hs-CRP and sLOX-1 receptor are inflammation biomarkers and in acute coronary syndrome patients they are associated with the severity of coronary artery disease and higher atherosclerotic plaque burden. We did not find any effect of statins on hs-CRP and sLOX-1 receptor levels during inhospital period. Statin may show their early effects through different mechanisms during in-hospital period. Key words: acute coronary syndromes, vascular inflammation, statins, sLOX-1 receptor, hs-CRP