Statin Reduces C-Reactive Protein and Interleukin-6 in Normocholesterolemic Patients with Acute Coronary Syndrome

Many evidences suggest that atherosclerosis is an inflammatory disease and inflammatory markers can be an important prognostic factors in acute coronary syndrome. Hydroxymethylglutaryl (HMG-CoA) redu- ctase inhibitors (statins) have been shown anti-inflammatory property that are independent of lipid-lowering effects. We evaluated the effects of 2-month treatment with simvastatin (40 mg/d, n=20) on plasma levels of circulating high-sensitivity C-reactive protein (hsCRP), inflammatory cytokines (tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6), and adhesion molecules (p-selectin and monocyte chemotactic peptide (MCP)-1) with placebo group (n=20) in 40 normocholesterolemic patients (LDL<130 mg/dl) with acute coronary syndrome. Simvastatin therapy significantly reduced plasma levels of total cholesterol and LDL-cholesterol (p=0.05, p=0.02, respectively) compared with placebo group. Simvastatin therapy also significantly reduced plasma levels of hsCRP and IL-6 (p=0.03, p=0.03, respectively) compared with placebo group. But, the reduction of hsCRP and IL-6 levels with simvastatin was unrelated to the degree of LDL-cholesterol's reduction. The effect of simvastatin on the reduction of hsCRP and IL-6, but not on the other inflammatory cytokines and adhesion molecules, have potential implications in the management of acute coronary syndrome with normocholesterolemia.