| 18565968 |
Divchev D, Grothusen C, Luchtefeld M, Thoenes M, Onono F, Koch R, Drexler H, Schieffer B: Impact of a combined treatment of angiotensin II type 1 receptor blockade and 3-hydroxy-3-methyl-glutaryl-CoA-reductase inhibition on secretory phospholipase A2-type IIA and low density lipoprotein oxidation in patients with coronary artery disease. Eur Heart J. 2008 Aug;29(16):1956-65. Epub 2008 Jun 18.
AIMS: To evaluate the impact of a combined treatment of angiotensin II type 1 (AT (1))-receptor blockade and 3-hydroxy-3-methyl-glutaryl-CoA-reductase inhibition (statin) on the secretory phospholipase A (2) type IIA (sPLA (2)-IIA) and oxidized low density lipoprotein (oxLDL) in patients with coronary artery disease (CAD). METHODS AND RESULTS: Sixty patients with angiographically documented CAD and a history of arterial hypertension were randomized in a double-blinded fashion to pravastatin (PRAV, 40 mg/day, n = 30) or PRAV plus irbesartan (PRAV+IRB, 40 mg/day+300 mg/day, n = 30) and were treated for 3 months. Blood pressure (BP) and cholesterol fractions were determined at baseline and after 3 months. SPLA (2) activity as primary endpoint, sPLA (2)-IIA protein, oxLDL levels, and high-sensitivity (hs)-C-reactive protein were measured by an enzyme-linked immunabsorbent assay. In both treatment groups, systolic BP levels and circulating HDL and LDL levels were reduced to the same extent. The combined treatment of PRAV+IRB significantly decreased sPLA (2)-IIA activity and sPLA (2)-IIA-protein concentration compared with PRAV treatment alone (P < 0.05). In addition, PRAV+IRB significantly reduced oxLDL levels compared with PRAV treatment alone (P < 0.05). This effect was independent of changes in LDL cholesterol levels. CONCLUSION: These findings are consistent with the notion that the combined treatment of pravastatin with irbesartan reduced sPLA (2)-IIA-activity, sPLA (2)-IIA-protein concentration, and oxLDL in patients with CAD suggesting a novel anti-atherogenic effect by combining AT (1)-receptor blockade with statin treatment. |
1(0,0,0,1) |