DOI QR코드

DOI QR Code

Rosuvastatin Reduces Blood Viscosity in Patients with Acute Coronary Syndrome

  • Jung, Lae-Young (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Lee, Sang-Rok (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Jung, Jin-Mu (Division of Mechanical Design Engineering, Chonbuk National University) ;
  • Kim, Yi-Shik (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Lee, Sun-Hwa (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Rhee, Kyoung-Suk (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Chae, Jei-Keon (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Lee, Dong-Hwan (Division of Mechanical Design Engineering, Chonbuk National University) ;
  • Kim, Dal-Sik (Department of Laboratory Medicine, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Kim, Won-Ho (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School) ;
  • Ko, Jae-Ki (Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School)
  • Received : 2015.03.07
  • Accepted : 2015.08.11
  • Published : 2016.03.30

Abstract

Background and Objectives: Wall shear stress contributes to atherosclerosis progression and plaque rupture. There are limited studies for statin as a major contributing factor on whole blood viscosity (WBV) in patients with acute coronary syndrome (ACS). This study investigates the effect of statin on WBV in ACS patients. Subjects and Methods: We prospectively enrolled 189 consecutive patients (mean age, $61.3{\pm}10.9years$; 132 males; ST-segment elevation myocardial infarction, n=52; non-ST-segment elevation myocardial infarction, n=84; unstable angina n=53). Patients were divided into two groups (group I: previous use of statins for at least 3 months, n=51; group II: statin-naïve patients, n=138). Blood viscosities at shear rates of 1 s-1 (diastolic blood viscosity; DBV) and 300 s-1 (systolic blood viscosity; SBV) were measured at baseline and one month after statin treatment. Rosuvastatin was administered to patients after enrollment (mean daily dose, $16.2{\pm}4.9mg$). Results: Baseline WBV was significantly higher in group II ([SBV: group I vs group II, $40.8{\pm}5.9mP$ vs. $44.2{\pm}7.4mP$, p=0.003], [DBV: $262.2{\pm}67.8mP$ vs. $296.9{\pm}76.0mP$, p=0.002]). WBV in group II was significantly lower one month after statin treatment ([SBV: $42.0{\pm}4.7mP$, p=0.012, DBV: $281.4{\pm}52.6mP$, p=0.044]). However, low-density lipoprotein cholesterol level was not associated with WBV in both baseline (SBV: $R_2=0.074$, p=0.326; DBV: $R_2=0.073$, p=0.337) and after one month follow up (SBV: $R_2=0.104$, p=0.265; DBV: $R_2=0.112$, p=0.232). Conclusion: Previous statin medication is an important determinant in lowering WBV in patients with ACS. However, one month of rosuvastatin decreased WBV in statin-naïve ACS patients.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

References

  1. Arbab-Zadeh A, Nakano M, Virmani R, Fuster V. Acute coronary events. Circulation 2012;125:1147-56. https://doi.org/10.1161/CIRCULATIONAHA.111.047431
  2. Kensey KR. The mechanistic relationships between hemorheological characteristics and cardiovascular disease. Curr Med Res Opin 2003;19:587-96. https://doi.org/10.1185/030079903125002289
  3. Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol 2006;47(8 Suppl):C13-8. https://doi.org/10.1016/j.jacc.2005.10.065
  4. Finn AV, Nakano M, Narula J, Kolodgie FD, Virmani R. Concept of vulnerable/unstable plaque. Arterioscler Thromb Vasc Biol 2010;30:1282-92. https://doi.org/10.1161/ATVBAHA.108.179739
  5. Marton Z, Horvath B, Alexy T, et al. Follow-up of hemorheological parameters and platelet aggregation in patients with acute coronary syndromes. Clin Hemorheol Microcirc 2003;29:81-94.
  6. Cho YI, Kensey KR. Effects of the non-Newtonian viscosity of blood on flows in a diseased arterial vessel. Part 1: steady flows. Biorheology 1991;28:241-62. https://doi.org/10.3233/BIR-1991-283-415
  7. Fuchs J, Pinhas A, Davidson E, Rotenberg Z, Agmon J, Weinberger I. Plasma viscosity, fibrinogen and haematocrit in the course of unstable angina. Eur Heart J 1990;11:1029-32. https://doi.org/10.1093/oxfordjournals.eurheartj.a059630
  8. Cho YI, Cho DJ. Hemorheology and microvascular disorders. Korean Circ J 2011;41:287-95. https://doi.org/10.4070/kcj.2011.41.6.287
  9. Lipowsky HH. Microvascular rheology and hemodynamics. Microcirculation 2005;12:5-15. https://doi.org/10.1080/10739680590894966
  10. Lee AJ, Mowbray PI, Lowe GD, Rumley A, Fowkes FG, Allan PL. Blood viscosity and elevated carotid intima-media thickness in men and women: the Edinburgh Artery Study. Circulation 1998;97:1467-73. https://doi.org/10.1161/01.CIR.97.15.1467
  11. Lee SR, Jung JM, Jung LY, et al. Elevated coronary whole blood viscosity in acute coronary syndrome patients. Clin Hemorheol Microcirc 2013;55:85-94.
  12. Sezer M, Oflaz H, Goren T, et al. Intracoronary streptokinase after primary percutaneous coronary intervention. N Engl J Med 2007;356:1823-34. https://doi.org/10.1056/NEJMoa054374
  13. Moriarty PM, Gibson CA, Kensey KR, Hogenauer W. Effect of low-density lipoprotein cholesterol apheresis on blood viscosity. Am J Cardiol 2004;93:1044-6. https://doi.org/10.1016/j.amjcard.2003.12.059
  14. Rosenson RS, Tangney CC. Antiatherothrombotic properties of statins: implications for cardiovascular event reduction. JAMA 1998;279:1643-50. https://doi.org/10.1001/jama.279.20.1643
  15. Vaughan CJ, Murphy MB, Buckley BM. Statins do more than just lower cholesterol. Lancet 1996;348:1079-82. https://doi.org/10.1016/S0140-6736(96)05190-2
  16. Beigel Y, Fuchs J, Snir M, Green P, Lurie Y, Djaldetti M. Lovastatin therapy in hypercholesterolemia: effect on fibrinogen, hemorrheologic parameters, platelet activity, and red blood cell morphology. J Clin Pharmacol 1991;31:512-7. https://doi.org/10.1002/j.1552-4604.1991.tb03729.x
  17. Jay RH, Rampling MW, Betteridge DJ. Abnormalities of blood rheology in familial hypercholesterolaemia: effects of treatment. Atherosclerosis 1990;85:249-56. https://doi.org/10.1016/0021-9150(90)90117-2
  18. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischemic heart disease, and stroke: systemic review and meta-analysis. BMJ 2003;326:1423. https://doi.org/10.1136/bmj.326.7404.1423
  19. Kim H, Cho YI, Lee DH, et al. Analytical performance evaluation of the scanning capillary tube viscometer for measurement of whole blood viscosity. Clin Biochem 2013;46:139-42. https://doi.org/10.1016/j.clinbiochem.2012.10.015
  20. Shin S, Hou JX, Suh JS, Singh M. Validation and application of a microfluidic ektacytometer (RheoScan-D) in measuring erythrocyte deformability. Clin Hemorheol Microcirc 2007;37:319-28.
  21. Holsworth RE Jr, Cho YI, Weidman JJ, Sloop GD, St Cyr JA. Cardiovascular benefits of phlebotomy: relationship to changes in hemorheological variables. Perfusion 2014;29:102-16. https://doi.org/10.1177/0267659113505637
  22. Rosenson RS, Wolff D, Green D, Boss AH, Kensey KR. Aspirin . Aspirin dose not alter native blood viscosity. J Thromb Haemost 2004;2:340-1. https://doi.org/10.1111/j.1538-79333.2004.0615f.x
  23. Froom P. Blood viscosity and the risk of death from coronary heart disease. Eur Heart J 2000;21:513-4. https://doi.org/10.1053/euhj.1999.1923
  24. Jung JM, Lee DH, Kim KT, et al. Reference intervals for whole blood viscosity using the analytical performance-evaluated scanning capillary tube viscometer. Clin Biochem 2014;47:489-93. https://doi.org/10.1016/j.clinbiochem.2014.01.021
  25. Banyai S, Banyai M, Falger J, et al. Atorvastatin improves blood rheology in patients with familial hypercholesterolemia (FH) on long-term LDL apheresis treatment. Atherosclerosis 2001;159:513-9. https://doi.org/10.1016/S0021-9150(01)00532-9
  26. Bo M, Bonino F, Neirotti M, et al. Hemorheologic and coagulative pattern in hypercholesterolemic subjects treated with lipid-lowering drugs. Angiology 1991;42:106-13. https://doi.org/10.1177/000331979104200204
  27. Ditzel J, Kampmann J. Whole-blood viscosity, hematocrit and plasma protein in normal subjects at different ages. Acta Physiol Scand 1971;81:264-8. https://doi.org/10.1111/j.1748-1716.1971.tb04899.x

Cited by

  1. Blood Viscosity Is a Fingerprint or a Modifiable Identity Card in Younger Patients With Myocardial Infarction vol.68, pp.7, 2016, https://doi.org/10.1177/0003319716668935
  2. Effect of hemorheological parameters on myocardial injury after primary or elective percutaneous coronary intervention vol.29, pp.8, 2016, https://doi.org/10.1097/mca.0000000000000661
  3. Prior antithrombotic use is significantly associated with decreased blood viscosity within 24 hours of symptom onset in patients with acute ischemic stroke vol.12, pp.2, 2016, https://doi.org/10.18700/jnc.190092
  4. The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients vol.13, pp.2, 2016, https://doi.org/10.18700/jnc.200023
  5. Therapeutic Efficacy and Safety of Safflower Injection in the Treatment of Acute Coronary Syndrome vol.2021, pp.None, 2016, https://doi.org/10.1155/2021/6617772
  6. A Review of Red Yeast Rice, a Traditional Fermented Food in Japan and East Asia: Its Characteristic Ingredients and Application in the Maintenance and Improvement of Health in Lipid Metabolism and the vol.26, pp.6, 2021, https://doi.org/10.3390/molecules26061619