Antioxidant effects of statins in patients after coronary angioplasty

Abstract

Background: Oxidative stress, characterized by an imbalance between the generation reactive oxygen species (ROS) and the capacity of the intrinsic antioxidant defense system, may be implicated in the pathogenesis of cardiovascular diseases. Percutaneous transluminal coronary angioplasty (PCI) followed by the implantation coronary stents may be associated with a process of ischemia and reperfusion related injury. PCI and stent deployment induce production of vascular reactive oxygen species (ROS) and reactive nitrogen species (RNS), leading to post-procedural pathophysiological changes, including restenosis, stent thrombosis, and endothelial dysfunction. The aim of the present study was to demonstrate, through the analysis of such parameters as Malondialdehyde (MDA), Superoxide dismutase (SOD) and Catalase, those early changes in oxidative stress take place in stable coronary artery disease (CAD) patients undergoing elective PCI with implantation of coronary stents. Material and methods: In this study 120 consecutive chronic stable angina pectoris patients (mean age 59 ± 0,63 years, 80% male) undergoing PCI for management of single and multi -vessel CAD were included. Malondialdehyde, Superoxide dismutase and Catalase enzymes activity were measured before and after the procedure, as well as 24 hours later, then after 1, 3, 6 months. Simvastatin was administered at different doses: group I received – 20 mg, group II received – 40 mg of simvastatin and group III – 80 mg 12 hours before the angioplasty with stent implantation. Results: The obtained outcomes indicate that the oxidative stress activity increased in the patients with CAD versus control group. Traumatic impact by expanding stent pressure was observed within 24 hours after angioplasty by raising MDA and lowering SOD and Catalase. Conclusions: Pleiotropic antioxidant effects of simvastatin administered to patients after revascularization, manifested by abolishing oxidative stress (DAM) and raising antioxidant enzymes (SOD, Catalase) in the next steps 1, 3, 6 months after PCI.