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N. A. Gratsianskiĭ

Publications and source records attributed to N. A. Gratsianskiĭ.

2 recordsLinked to original sources

[Statins as Anti-Inflammatory Agents]

Statins modify cellular composition of atherosclerotic plaques decreasing their inflammatory elements capable to produce plaque destabilizing metalloproteinases and prothrombotic tissue factor. In humans long term administration of these drugs leads to decrease of levels of markers of inflammation notably of C-reactive protein. Possible mechanisms of anti-inflammatory action of statins include activation of peroxisome proliferator activated receptor alpha. Indirect evidence exists from studies with clinical end points that statins are effective in patients with elevated initial level of C-reactive protein (CARE) and that this phenomenon occurs irrespective of the initial LDL CH level (AFCAPS) and its changes during statin therapy. Thus administration of statins apparently is an intervention capable to selectively modify the harmful components of inflammation in the arteries and to create new avenue for the management of patients with cardiovascular disease who do not have hypercholesterolemia (R.Ross).

Editorial↗

[Results of 6-Month Follow-up of Patients With Non-ST-Elevation Acute Coronary Syndrome Treated With Enoxaparin. Data of Multicenter Study in Russia]

Two hundred eighty four patients aged 30-85 (mean 62-/+10.2) years hospitalized because of prolonged attack of rest angina were included into open noncomparative study of enoxaparin tolerability. In addition to conventional aspirin the patients received enoxaparin (1 mg or 100 anti-Xa U/kg subcutaneously) every 12 hours for 2-8 days. Events registered during follow-up for 6 months were deaths, nonfatal myocardial infarctions, attacks of angina with new ischemic ECG changes during initial hospitalization, and anginal attacks causing repeat hospitalization. Total number of patients with these events during first 15 days was 11.3% (including 1 death and 3 nonfatal myocardial infarctions). After 6 months number of events almost doubled and reached 20.6%. Most pronounced was increase in numbers of deaths and nonfatal infarctions (up to 11 and 10 events, respectively). During period of follow-up most of patients continued to take aspirin and beta blockers, while myocardial revascularization was performed in 6 patients, and use of statins was negligible. Among 32 parameters (demographic data, medical history, characteristics of index exacerbation of coronary artery disease and therapy) included into multifactorial analysis only actual decisions of physicians (prolongation of treatment with enoxaparin, the use of calcium antagonists) were independent predictors of angina recurrence. Apparently these decisions better reflected real severity of patients clinical condition then ihobjectiveln parameters registered by investigators.

Journal Article↗