Low dose rofecoxib, inflammation and prostacyclin synthesis in acute coronary syndromes.

A M Kuklińska, W J Musiał, K A Kamiński, P Kralisz, W Modrzejewski, B Sobkowicz, S Dobrzycki, S Stec, I Wojtkowska
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Abstract

Purpose: To assess the influence of low dose rofecoxib on inflammatory mediators and prostacyclin synthesis in patients with acute coronary syndromes (ACS) in a short-term follow up.

Material and methods: Twenty nine patients with ACS without ST elevation were randomized to simvastatin alone or together with low dose rofecoxib. Serum levels of interleukin 6 (IL-6), 6-keto-PGF-1alpha--stable product of prostacyclin (PGT2) and hs-C-reactive protein (hs-CRP) were assessed on enrollment and after 30-day follow up.

Results: Combination of rofecoxib with statin significantly decreased levels of hs-CRP after one month therapy (5.21 mg/l +/- 4.12 vs 2.11 mg/l +/- 2.1; p=0.0092). This effect was not evident in a group on statin alone (3.95 mg/l +/- 3.33 vs 2.48 mg/l +/- 2.39; p=0.31). 6-keto-PGF-1alpha increased not significantly in both groups. IL-6 concentration has not changed during follow up.

Conclusions: Low dose of selective COX-2 inhibitor exerts significant anti-inflammatory effect and does not diminish PG12 synthesis in study group of patients with ACS.

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低剂量罗非昔布、炎症和前列环素在急性冠脉综合征中的合成。
目的:评价低剂量罗非昔布对急性冠脉综合征(ACS)患者炎症介质和前列环素合成的影响。材料与方法:29例无ST段抬高的ACS患者随机接受辛伐他汀单用或低剂量罗非昔布联合治疗。在入组时和随访30天后评估血清白细胞介素6 (IL-6)、6-酮- pgf -1 α——前列环素(PGT2)稳定产物和hs- c反应蛋白(hs-CRP)水平。结果:罗非昔布联合他汀治疗1个月后显著降低hs-CRP水平(5.21 mg/l +/- 4.12 vs 2.11 mg/l +/- 2.1;p = 0.0092)。这种影响在单独使用他汀类药物的组中不明显(3.95 mg/l +/- 3.33 vs 2.48 mg/l +/- 2.39;p = 0.31)。6-酮- pgf -1 α在两组均无明显升高。随访期间IL-6浓度无变化。结论:低剂量选择性COX-2抑制剂对ACS患者具有明显的抗炎作用,且不影响PG12的合成。
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