CLINICAL AND FUNCTIONAL COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE COMBINED WITH ISCHEMIC HEART DISEASE AGAINST THE BACKGROUND OF COMPLEX THERAPY WITH CRESTOR

The article shows the results of prospective research of clinical and functional course of chronic obstructive pulmonary disease combined with ischemic heart disease in 39 patients. The standard therapy of 21 patients was supplemented with Crestor^® (rosuvastatin calcium), the inhibitor of HMG-CoA-reductase of the fourth generation and the therapy of 17 patients did not include Сrestor^®. The observations were made throughout the year. It was found out that the combination of crestor with the standard therapy of chronic obstructive pulmonary disease and ischemic heart disease contributes to the control over the symptoms of the combined pathology (it decreases the intensity of short breath, sputum production, the frequency and intensity of the cough, the frequency of angina attacks) and 1.9 times reduces the frequency of exacerbations and the severity of comorbid pathology. Long application of Crestor^® combined with the standard therapy leads to the increase of FEV₁ by 7.04±1.86%, FEV₁/FVC by 7.16±1.62% and to the decrease of arterial stiffness and the activity of laboratory parameters of the systemic inflammation. The research proves the significant anti-inflammatory effect of Crestor^® and the feasibility of its application while treating chronic obstructive pulmonary disease.

chronic obstructive pulmonary disease, ischemic heart disease, statins, systemic inflammation, airway conductance, arterial stiffness

1. Авдеев С.Н. Хроническая обструктивная болезнь легких как системное заболевание // Пульмонология. 2007. №2. С.104-116.

2. Кубышева Н.И., Постникова Л.Б. Системное воспаление: перспектива исследований, диагностики и лечения хронической обструктивной болезни легких // Клин. геронтол. 2007. Т.13, №7. С.50-56.

3. Невзорова В.А., Бархатова Д.А. Системное воспаление и состояние скелетной мускулатуры больных хронической обструктивной болезнью легких // Тер. арх. 2008. Т.80, №3. С.85-90.

4. Прибылов С.А. Провоспалительные цитокины при хронической обструктивной болезни легких // Вестн. новых мед. технол. 2007. Т.10, №1. С.25-28.

5. Прозорова Г.Г., Волкорезов И.А., Пашкова О.В. Системное воспаление и особенности клинического течения хронической обструктивной болезни легких // Науч.-мед. вестн. Центр. Черноземья. 2009. №37. С.34-40.

6. Цветкова О.А., Агапова О. Ю. Перспективы применения статинов в лечении больных с хронической обструктивной болезнью легких // Рос. мед. вести. 2011. Т.16, №3. С.4-12.

7. Чичерина Е.Н., Милютина О.В. Системное воспаление и атеросклероз общих сонных артерий у больных хронической обструктивной болезнью легких // Клин. мед. 2009. №2. С.18-20.

8. Cholesterol Treatment Trialists× Collaboration. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90056 participants in 14 randomised trials of statins // Lancet. 2005. Vol.366, Iss. 9493. Р.1267-1278.

9. Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial / J.R.Crouse 3rd <http://www.ncbi.nlm.nih.gov/pubmed?term=Crouse%20JR%203rd%5BAuthor%5D&cauthor=true&cauthor_uid=17384434> [et al.] // JAMA. 2007. Vol.297, №12. Р.1344-1353.

10. Global Initiative for Chronic Obstructive Lung Diseases (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. NHLBI/WHO workshop report. Updated 2009. URL: http://www.goldcopd.org.

11. Langen R.C., Schols A.M. Inflammations: friend or foe of muscle remodeling in COPD? // Eur. Respir. J. 2007. Vol.30, №4. P.605-607.

12. Arterial stiffness is independently associated with emphysema severity in patients with chronic obstructive pulmonary disease / D.A.McAlilster [et al.] // Am. J. Respir. Crit. Care Med. 2007. Vol.176, №12. P.1208-1214.

13. Paraskevas K.I ., Stathopoulos V ., Mikhailidis D.P . Pleiotropic effects of statins: implications for a wide range of diseases // Curr. Vasc. Pharmacol. 2008. Vol.6, №4. Р.237-239.

14. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial / P.M.Ridker [et al.] // Lancet. 2009. Vol.373. Р.1175-1182.

15. Effects of switching statins on achievement of lipid goals: Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy (MERCURY I) study / H.Schuster [et al.] // Am. Heart J. 2004. Vol.147, №4. Р.705-713.

16. Avdeev S.N. Pul'monologiya 2007; 2:104-116.

17. Kubysheva N.I., Postnikova L.B. Klinicheskaya gerontologiya 2007; 13(7):50-56.

18. Nevzorova V.A., Barkhatova D.A. Terapevticheskii arkhiv 2008; 80(3):85-90.

19. Pribylov S.A. Vestnik novykh meditsinskikh tekhnologiy 2007; 10(1):25-28.

20. Prozorova G.G., Volkorezov I.A., Pashkova O.V. Nauchno-meditsinskiy vestnik Tsentral'nogo Chernozem'ya 2009; 37:34-40.

21. Tsvetkova O.A., Agapova O. Yu. Rossiyskie meditsinskie vesti 2011; 16(3): 4-12.

22. Chicherina E.N., Milyutina O.V. Klinicheskaya meditsina 2009; 2: 18-20.

23. Cholesterol Treatment Trialists× Collaboration. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90056 participants in 14 randomised trials of statins. Lancet 2005; 366(9493):1267-1278.

24. Crouse J.R. , Raichlen J.S ., Riley W.A ., Evans G.W ., Palmer M.K ., O'Leary D.H ., Grobbee D.E ., Bots M.L .; METEOR Study Group . Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial. JAMA 2007; 297(12): 1344-1353.

25. Global Initiative for Chronic Obstructive Lung Diseases (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. NHLBI/WHO workshop report. Updated 2009. Available at: http://www.goldcopd.com.

26. Langen R.C., Schols A.M. Inflammations: friend or foe of muscle remodeling in COPD? Eur. Respir. J. 2007; 30(4):605-607.

27. McAllister D.A ., Maclay J.D , Mills N.L _., Mair G ., Miller J ., Anderson D ., Newby D.E ., Murchison J.T ., Macnee W . Arterial stiffness is independently associated with emphysema severity in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2007; 176(12): 1208-1214.

28. Paraskevas K.I ., Stathopoulos V., Mikhailidis D.P. Pleiotropic effects of statins: implications for a wide range of diseases. Curr. Vasc. Pharmacol. <http://www.ncbi.nlm.nih.gov/pubmed/18855711> 2008; 6(4):237-239..

29. Ridker P.M ., Danielson E ., Fonseca F.A ., Genest J ., Gotto A.M. Jr ., Kastelein J.J ., Koenig W ., Libby P ., Lorenzatti A.J ., Macfadyen J.G ., Nordestgaard B.G ., Shepherd J ., Willerson J.T ., Glynn R.J .; JUPITER Trial Study Group . Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009; 373(9670):1175-1182.

30. Schuster H ., Barter P.J ., Stender S ., Cheung R.C ., Bonnet J ., Morrell J.M ., Watkins C ., Kallend D ., Raza A .; Effective Reductions in Cholesterol Using Rosuvastatin Therapy I study group . Effects of switching statins on achievement of lipid goals: Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy (MERCURY I) study. Am. Heart J. 2004; 147(4): 705-713.