The influence of simvastatin on selected inflammatory markers in patients with chronic obstructive pulmonary disease

Abstract

INTRODUCTION: There is growing evidence that chronic obstructive pulmonary disease (COPD) is a risk factor for coronary heart disease. Simvastatin is a hypolipemic drug with proven efficacy in the prevention of cardiovascular diseases. Observational studies showed that statins may be useful in the reduction of mortality from COPD. Experimental studies on animals showed anti-inflammatory effects of statins on the lung tissue. OBJECTIVES: The aim of this study was to evaluate the influence of simvastatin on inflammatory markers in patients with COPD. PATIENTS AND METHODS: Fifty-six patients (aged 44-80 years) with stable COPD (a mean forced expiratory volume in 1 second [FEV1] 55%), were randomly assigned (1:1) to receive simvastatin 40 mg/day or to receive no statin treatment. Blood samples were collected before, 2 weeks, and 3 months after statin administration. The levels of fibrinogen, C-reactive protein (CRP), tumor necrosis factor-alpha, interleukin 6 (IL-6), and matrix metalloproteinase-9 were measured. RESULTS: The groups did not differ significantly in terms of demographic data, clinical symptoms, pharmacological treatment, spirometry, and lipid profile at baseline. Among comorbidities only arterial hypertension was more frequent in the statin group (32.1% vs. 17.9%, P = 0.03). After 2 weeks as well as 3 months of simvastatin treatment, no significant reduction of any measured inflammatory markers was observed. There was a nonsignificant reduction of CRP and IL-6 in the subgroup with FEV1 >50% during simvastatin treatment. There was a decrease in total cholesterol (from 5.7 to 4.7 mmol/l, P = 0.0018) and low-density lipoprotein cholesterol (from 3.46 to 2.47 mmol/l, P = 0.000037) in the statin group. CONCLUSIONS: In COPD patients, a 3-month treatment with simvastatin does not reduce circulating inflammatory markers.