Effects Of Probucol On Endothelial Function In Patients With Acute Coronary Syndrome

Objective:Vaseular endothelial injury Plyas a critical role in the pathogenesis and Porgression of the coronary heart disease(CHD).A growing body of evidence suggests that endothelial Dysufnetion is associated with cardiovascular events.Oxidized low-density liPoProtein(ox-LDL) is thought to contribute to The endothelial dysufnetion and Pathogenesis of atheroselerosis, but the relationship of between the cardiac oxidative stress and acute coronary syndrome(ACS) were unclear. The antioxidant probucolHas been proposed as a promising role against atheroselerosis and restenosis. The aim of study was to invertigate the cardiac oxidative stress, vaseular endothelial injury and their correlations to clinic manifestation in patients with stable angina(SA)or ACS.To explore.The relation of the Plasma ox-LDL level and endothelial flow mediated vasodilation(FMD) in ACS Patients. The study investigate probucol combined with simvastatin on endothelial function in patients with acute coronary syndrome(ACS).Method:A total of 60 ACS patients randomly received standard therapy plus simvastatin (A,n=30) or standard therapy plus probucol combined with simvastatin (B,n=30). Plasma oxidized low-density lipoprotein(ox-LDL) and nitric oxide(NO) were measured.The brachial arterial hyperemia-induced flow mediated dilation(FMD) mediated vasodilatations were measured by high resolution ultrasound. These variables were analyzed before and after 3 months.Results:Plasma NO and FMD was significantly increased after 3 months therapy thanbefore(65.69±10.9μmol/Lvs48.47±11.2μmol/L,P<0.001;(9.35±1.18)%vs(7.25±1.23)%.P<0.001.respectively],while ox-LDL was significantly decreased (605.7±87.2 mg/L vs 480.7±85.4mg/L P<0.001) in A group. Plasma NO and FMD was increased after 3 months therapy than before (80.39±12.4μmol/L vs 49.58±12.5μmol/L, P<0.001);(12.85±1.18)% vs (7.30±1.02)%, P<0.05 respectively],while ox-LDL was decreased (603.9±85.9 mg/L vs 402.4±86.7 mg/L P<0.001) in B group. After 3 months therapy,Plasma NO and FMD was significantly increased in B group than in A group (80.39±12.4μmol/L vs 65.69±10.9μmol/L,P<0.01);(12.85±1.18)%vs(9.35±1.18)%, P<0.05,respectively], while ox-LDL was significantly decreased (480.7±85.4 mg/L vs 402.4±86.7 mg/L P <0.01) in B group than in A group.Conclusion:1. Oxidized LDL not only Plays an important role in coronary endothelial dysufnetion, but also contributes to the progress in the acute coronary syndrome. Oxidative stress may be one of the pahtophysiological basis of acute coronary events.2. Antioxidative and antinflmamation therapies were important strategy inclinical Treartment of the acute coronary syndrome, but futher mechanisms were to study deeply In the furture.3. It was important that Vaseular endothelial function and brachial arterial endothelial dependent vasodilation reaction may be improved in the ACS patienis of after the antioxidant probucol hetrpahy. Probueol used in ACS clinical teartment may be available srtategy.