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Simvastatin increases neutrophil apoptosis and reduces inflammatory reaction after coronary surgery.
Abstract
Background Neutrophils play a central role in systemic inflammatory reaction after cardiopulmonary bypass. Apoptosis is significantly delayed, and this might exacerbate systemic and myocardial damage. We tested the hypothesis of whether pretreatment with simvastatin increases the apoptotic rate of neutrophils and hence reduces the entity of inflammatory reaction.Methods Thirty patients undergoing coronary surgery with cardiopulmonary bypass were randomized to treatment with either simvastatin (40 mg/day) or placebo for 3 weeks before surgery. A group of 15 patients undergoing off-pump coronary surgery served as controls. Blood samples for detection of serum cytokine levels were obtained before anesthesia, at the end of surgery, and at 4, 24, 48, and 72 hours postoperatively. Apoptosis and indices of activation were assessed in cultured neutrophils.Results Simvastatin significantly reduced the postoperative peak values of interleukin (IL)-6 and IL-8. The neutrophil apoptotic rate was significantly higher among neutrophils obtained from patients pretreated with simvastatin (p < 0.05 at both 8 and 24 hours) compared with placebo. Neutrophils from the statin group had depressed functional activity, as underscored by significantly lower values of CD11b (p < 0.01 at 24 hours) and a significantly less percentage of cells positive for nitro-blue tetrazolium (p < 0.01 at 12 and 24 hours) compared with placebo.Conclusions This randomized, double-blind study indicates that statin therapy before cardiopulmonary bypass is associated with reduction of circulating markers of inflammation and increased neutrophil apoptosis. These data support a routine inclusion of statins as an adjuvant pharmacologic therapy before cardiopulmonary bypass surgery.
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“Moreover, simvastatin was demonstrated to enhance neutrophil apoptosis (Chello et al., 2007).”
From Atorvastatin Reduces the Survival of Candida albicans-Infected BALB/c Mice (2015) · cites this paper as Chello et al., 2007
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Metadata
- Authors
- Chello, M., Anselmi, A., Spadaccio, C., Patti, G., Goffredo, C., Di Sciascio, G., & Covino, E.
- Affiliations
- Università Campus Bio-Medico (IT)
- Corresponding author
- Chello, Massimo
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2007-04
- Volume
- 83
- Issue
- 4
- Pages
- 1374-1380
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2165560542
- Cited by
- 105
- References
- 26
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 2 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 8 · 2015: 7 · 2014: 3 · 2013: 4 · 2012: 8
- FWCI
- 10.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- simvastatin, statins, neutrophil apoptosis, systemic inflammatory response, cardiopulmonary bypass, coronary artery surgery, interleukin-6, interleukin-8, CD11b, nitroblue tetrazolium, preoperative statin therapy, adjuvant pharmacotherapy
- MeSH terms
- Aged, Coronary Artery Bypass, Coronary Disease, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Complications, Preoperative Care, Probability, Reference Values, Severity of Illness Index, Survival Rate, Cytokines, Treatment Outcome, Coronary Angiography, Apoptosis, Neutrophil Activation, Risk Assessment, Systemic Inflammatory Response Syndrome, Simvastatin
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