Antioxidant effects of simvastatin in patients with coronary heart disease and dyslipidemia
Aim. To investigate the effects of simvastatin therapy on antioxidant enzyme activity and the correction of disturbed antioxidant status in patients with coronary heart disease (CHD) - post-infarction cardiosclerosis (PICS) - in combination with dyslipidemia (DLP). Material and methods. The study included 132 CHD patients with PICS and 20 healthy controls. All participants underwent the measurement of plasma levels of lipids, lipid peroxidation (LP) products - diene conjugates (DC) and 2-thiobarbituric acid reagents (TBAR), antioxidant enzymes - glutathione peroxidase (GP) and superoxide dismutase (SOD) in red blood cells, plasma activity of the antioxidant ceruloplasmin/transferrin system (AOS CP/TF) (electron paramagnetic resonance method), and 24-hour Holter monitoring of electrocardiogram (ECG). Results. The three-month simvastatin therapy (20 mg/day), as a component of the complex cardiac treatment, demonstrated its antioxidant effects and antiperoxidation activity in 60% of CHD patients. The subsequent therapy with 2-ethyl-6-methyl-3-hydroxypyridine sulphate (ES; 375 mg/day) and ubidecarenone (30 mg/ day) normalised the parameters of LP-antioxidant defence (AOD) and the levels of hepatic transaminases. Plasma AOS CP/TF activity inversely correlated with the duration of myocardial ischemia in CHD patients (r=-0,34; p=0,004). Conclusion. To optimise the treatment of atherogenic DLP in simvastatin-treated CHD patients, ubidecarenone and ES could be used to improve the LP-AOD parameters.