STATINS AND PRO-INFLAMMATORY CYTOKINES IN IHD AFTER CORONARY STENTING
Keywords:
Percutaneous coronary intervention, Ischemic heart disease, Statins, Pro-inflammatory cytokines, Tumor necrosis factor, Atherosclerosis, Stenting of coronary arteries, Covid-19, SARSCoV-2Abstract
Today, the problem of ischemic heart disease remains the main cause of cardiovascular complications and death. With the development and implementation of new technologies for percutaneous coronary intervention (PCI), the problem of choosing between radical and conservative management of patients is becoming more and more urgent. The role of PCI in the treatment of patients with coronary artery disease has two main objectives: improving the prognosis and reducing the severity of angina pectoris and improving the quality of life. The main cause of coronary artery disease is atherosclerosis, which is influenced by inflammatory mediators, various proteins, proteins, enzymes of the lipid transport system and markers of myocardial damage. The primary trigger of the atherosclerotic process is the increased content of cytokines in the peripheral blood against the background of fluctuations in the initial cholesterol level. Atherogenic cholesterol is the central initial factor of cytokine overproduction in atherogenesis. Endothelial dysfunction is an early, preclinical phase of the development of coronary atherosclerosis and can be considered as the "gold standard" in assessing the functional state of the endothelium. A positive effect on endothelial function has been demonstrated in HMG-CoA reductase inhibitors, in particular rosuvastatin, which thus reduces the risk of PCI-related adverse events. Statins, in addition to their main hypolipidemic effect, have pleiotropic properties - anti-inflammatory, antithrombotic, and immunomodulatory effects. In addition, initial retrospective clinical trials have shown that statins have the potential to improve clinical outcomes in COVID-19 patients. If these benefits are proven in randomized trials, statins could also be a useful therapy for COVID-19. Despite the conduct of dozens of multicenter studies that have proven the hypolipidemic properties of statins, in particular, rosuvastatin, their questions regarding the correction of EF, lipid FRO processes, and the inflammatory reaction at the site of atherogenesis remain insufficiently studied, and this, in turn, has an important prognostic value.
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