1
|
Godoy JC, Niesman IR, Busija AR, Kassan A, Schilling JM, Schwarz A, Alvarez EA, Dalton ND, Drummond JC, Roth DM, Kararigas G, Patel HH, Zemljic-Harpf AE. Atorvastatin, but not pravastatin, inhibits cardiac Akt/mTOR signaling and disturbs mitochondrial ultrastructure in cardiac myocytes. FASEB J 2018; 33:1209-1225. [PMID: 30169110 DOI: 10.1096/fj.201800876r] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Statins, which reduce LDL-cholesterol by inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, are among the most widely prescribed drugs. Skeletal myopathy is a known statin-induced adverse effect associated with mitochondrial changes. We hypothesized that similar effects would occur in cardiac myocytes in a lipophilicity-dependent manner between 2 common statins: atorvastatin (lipophilic) and pravastatin (hydrophilic). Neonatal cardiac ventricular myocytes were treated with atorvastatin and pravastatin for 48 h. Both statins induced endoplasmic reticular (ER) stress, but only atorvastatin inhibited ERK1/2T202/Y204, AktSer473, and mammalian target of rapamycin signaling; reduced protein abundance of caveolin-1, dystrophin, epidermal growth factor receptor, and insulin receptor-β; decreased Ras homolog gene family member A activation; and induced apoptosis. In cardiomyocyte-equivalent HL-1 cells, atorvastatin, but not pravastatin, reduced mitochondrial oxygen consumption. When male mice underwent atorvastatin and pravastatin administration per os for up to 7 mo, only long-term atorvastatin, but not pravastatin, induced elevated serum creatine kinase; swollen, misaligned, size-variable, and disconnected cardiac mitochondria; alteration of ER structure; repression of mitochondria- and endoplasmic reticulum-related genes; and a 21% increase in mortality in cardiac-specific vinculin-knockout mice during the first 2 months of administration. To our knowledge, we are the first to demonstrate in vivo that long-term atorvastatin administration alters cardiac ultrastructure, a finding with important clinical implications.-Godoy, J. C., Niesman, I. R., Busija, A. R., Kassan, A., Schilling, J. M., Schwarz, A., Alvarez, E. A., Dalton, N. D., Drummond, J. C., Roth, D. M., Kararigas, G., Patel, H. H., Zemljic-Harpf, A. E. Atorvastatin, but not pravastatin, inhibits cardiac Akt/mTOR signaling and disturbs mitochondrial ultrastructure in cardiac myocytes.
Collapse
Affiliation(s)
- Joseph C Godoy
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Ingrid R Niesman
- Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Anna R Busija
- Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Adam Kassan
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA.,Department of Pharmaceutical Sciences, School of Pharmacy, West Coast University, North Hollywood, California, USA
| | - Jan M Schilling
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Anna Schwarz
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Erika A Alvarez
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Nancy D Dalton
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - John C Drummond
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - David M Roth
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Georgios Kararigas
- Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Hemal H Patel
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Alice E Zemljic-Harpf
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| |
Collapse
|
2
|
Lee CH, Lee SH, Park JS, Kim YJ, Kim KS, Chae SC, Kim HS, Choi DJ, Cho MC, Rha SW, Jeong MH. Impact of statin usage patterns on outcomes after percutaneous coronary intervention in acute myocardial infarction: Korea Working Group on Myocardial Infarction registry (KorMI) study. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2014; 11:93-9. [PMID: 25009557 PMCID: PMC4076447 DOI: 10.3969/j.issn.1671-5411.2014.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 12/30/2022]
Abstract
Background The benefit of statin use after acute ST-segment elevation myocardial infarction (STEMI) has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention (PCI). Methods This analysis of the Korea Working Group on Myocardial Infarction registry (KorMI) study included 3,584 STEMI patients (mean age, 63 ± 13 years; male, 2,684, 74.9%) undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events (MACE: all-cause death, recurrent MI, and target lesion revascularization) were compared among patients grouped according to statin therapy timing: I, both during and after hospitalization (n = 2,653, 74%); II, only during hospitalization (n = 309, 8.6%); III, only after discharge (n = 157, 4.4%); and IV, no statin therapy (n = 465, 13%). Mean follow-up duration was 234 ± 113 days. Results Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups III and IV had the highest MACE rates (2.3%, 3.9%, 5.1%, and 4.9% for groups I-IV, respectively, P = 0.004). After adjusting for confounders, groups II-IV had a higher MACE risk than group I [hazard ratio (HR): 3.20, 95% confidence interval (95%CI): 1.31–7.86, P = 0.011; HR: 3.84, 95%CI: 1.47–10.02, P = 0.006; and HR: 3.17, 95%CI: 1.59–6.40, P = 0.001; respectively]. Conclusions This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical practice.
Collapse
Affiliation(s)
- Chan-Hee Lee
- Department of Cardiology, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-717, South Korea
| | - Sang-Hee Lee
- Department of Cardiology, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-717, South Korea
| | - Jong-Seon Park
- Department of Cardiology, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-717, South Korea
| | - Young-Jo Kim
- Department of Cardiology, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-717, South Korea
| | - Kee-Sik Kim
- Department of Internal Medicine, Daegu Catholic University Hospital, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 705-718, South Korea
| | - Shung-Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 700-721, South Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173-gil, Bundang-gu, Seongnam, 463-707, South Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, 776, 1sunhwan-ro, Heungdeok-gu, Cheongju, 361-711, South Korea
| | - Seung-Woon Rha
- Department of Internal Medicine, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Myung-Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju, 501-757, South Korea
| | | |
Collapse
|
3
|
Kim MC, Ahn Y, Cho KH, Lee MG, Ko JS, Park KH, Sim DS, Yoon NS, Yoon HJ, Kim KH, Hong YJ, Park HW, Kim JH, Jeong MH, Cho JG, Park JC, Kang JC. Early statin therapy within 48 hours decreased one-year major adverse cardiac events in patients with acute myocardial infarction. Int Heart J 2011; 52:1-6. [PMID: 21321460 DOI: 10.1536/ihj.52.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
HMG-CoA reductase inhibitors (statins) reduce major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome. We investigated whether early statin therapy would be effective at reducing MACE in patients with acute myocardial infarction (AMI).A total of 1,159 patients were analyzed. They were grouped by initiation time of statin administration after admission as follows: group I; n = 945, ≤ 48 hours, group II; n = 214, > 48 hours.Cardiovascular risk factors and noncardiac comorbidities were not different between the two groups. ST-elevation MI as initial diagnosis was more prevalent in group I (68.4% versus 59.3%, P = 0.013). In-hospital mortality was not different in the two groups (0.8% versus 0.5%, P = 0.483). In one-year clinical follow-up, MACE and repercutaneous coronary intervention were lower in group I (17.8% versus 24.6%, P = 0.016, 10.2% versus 15.5%, P = 0.021, respectively). However, there was no difference in mortality (3.8% versus 4.7%, P = 0.319). In multivariate analysis, statin initiation within 48 hours after admission was an independent predictor of one-year MACE (OR 1.49, 95% CI = 1.00-2.21, P = 0.045).Consequently, early statin therapy within 48 hours after admission reduced MACE at one-year follow-up in patients with AMI.
Collapse
Affiliation(s)
- Min Chul Kim
- Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Paraskevas KI, Mikhailidis DP, Veith FJ. Mechanisms to explain the poor results of carotid artery stenting (CAS) in symptomatic patients to date and options to improve CAS outcomes. J Vasc Surg 2010; 52:1367-75. [DOI: 10.1016/j.jvs.2010.04.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/30/2010] [Accepted: 04/07/2010] [Indexed: 11/25/2022]
|
5
|
Miura SI, Saku K. Effects of statin and lipoprotein metabolism in heart failure. J Cardiol 2010; 55:287-90. [DOI: 10.1016/j.jjcc.2010.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 02/03/2010] [Indexed: 12/14/2022]
|
6
|
Park DJ, Jeong MH, Park KH, Sim DS, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC. Clinical Effects of Statin in Elderly Patients with Acute Myocardial Infarction and Left Ventricular Dysfunction Who underwent Percutaneous Coronary Intervention. Chonnam Med J 2010. [DOI: 10.4068/cmj.2010.46.2.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dong Jin Park
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Keun-Ho Park
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Doo Sun Sim
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Ju Han Kim
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jeong Gwan Cho
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jong Chun Park
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Center of Chonnam National University Hospital, Heart Research Center designated by Health, Welfare and Family Affairs, Gwangju, Korea
| |
Collapse
|
7
|
Yoshida S, Kamihata H, Nakamura S, Senoo T, Manabe K, Motohiro M, Sugiura T, Iwasaka T. Prevention of contrast-induced nephropathy by chronic pravastatin treatment in patients with cardiovascular disease and renal insufficiency. J Cardiol 2009; 54:192-8. [DOI: 10.1016/j.jjcc.2009.05.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 04/29/2009] [Accepted: 05/08/2009] [Indexed: 10/20/2022]
|
8
|
|
9
|
Kashima Y, Izawa A, Aizawa K, Koshikawa M, Kasai H, Tomita T, Kumazaki S, Tsutsui H, Koyama J, Ikeda U. Rationale and design of assessment of lipophilic vs. hydrophilic statin therapy in acute myocardial infarction (the ALPS-AMI) study. J Cardiol 2009; 54:76-9. [PMID: 19632524 DOI: 10.1016/j.jjcc.2009.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 04/15/2009] [Accepted: 04/20/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Statins reduce the incidence of cardiovascular events in patients with acute myocardial infarction (AMI). Although all statins are equally effective in secondary prevention, there might be certain differences in the effects of lipophilic and hydrophilic statins. Therefore, our aim is to compare the effectiveness of lipophilic atorvastatin and hydrophilic pravastatin in secondary prevention after AMI. METHODS AND RESULTS This study is a prospective, randomized, open-label, multicenter study of 500 patients with AMI. Patients that have undergone successful percutaneous coronary intervention will be randomly allocated to receive either atorvastatin or pravastatin with the treatment goal of lowering their low-density lipoprotein-cholesterol level below 100 mg/dl for 2 years. The primary endpoint will be death due to any cause, nonfatal MI, nonfatal stroke, unstable angina, or congestive heart failure requiring hospital admission, or any type of coronary revascularization. CONCLUSION This is the first multicenter trial to compare the effects and safety of lipophilic and hydrophilic statin therapy in Japanese patients with AMI. It addresses an important issue and could influence the use of statin treatment in the secondary prevention of coronary artery disease.
Collapse
Affiliation(s)
- Yuichiro Kashima
- Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Kishi T, Yamada A, Okamatsu S, Sunagawa K. Atorvastatin might improve ventricular electrostability and decelerate the deterioration of renal function in patients with heart failure and diabetes mellitus. J Cardiol 2009; 53:341-8. [PMID: 19477374 DOI: 10.1016/j.jjcc.2008.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 11/09/2008] [Accepted: 12/03/2008] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies suggested that statins have pleiotropic effects, such as improvements in endothelial function, as well as anti-inflammatory, anti-proliferative, and anti-oxidative effects. These effects might benefit patients with heart failure. In those patients, statins relieved symptoms, decreased the frequency of hospitalization, suppressed neurohumoral activation, and improved cardiac function. However, it remains unknown how statins impact pathophysiology of heart failure with diabetes mellitus. The aim of this study was to investigate the effects of atorvastatin on pathophysiology of heart failure with diabetes mellitus. METHODS AND RESULTS We enrolled retrospectively 128 patients with heart failure with diabetes mellitus who were admitted from January 2003 to December 2005. Among these patients, 80 received atorvastatin (statin group) and the remaining patients served as controls (non-statin group). At study entry, there were no significant differences in the patient profiles between the two groups except for the low-density lipoprotein cholesterol level being higher in the statin group. After the follow-up period of two years, the frequency of re-hospitalization, brain natriuretic peptide, premature ventricular contractions, Lown grade, and deterioration of glomerular filtration rate were significantly less in the statin group. CONCLUSION Atorvastatin might benefit patients with heart failure and diabetes mellitus by improving ventricular electrical stability and decelerating deterioration of renal function.
Collapse
Affiliation(s)
- Takuya Kishi
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan.
| | | | | | | |
Collapse
|
11
|
Teshima Y, Yufu K, Akioka H, Iwao T, Anan F, Nakagawa M, Yonemochi H, Takahashi N, Hara M, Saikawa T. Early atorvastatin therapy improves cardiac function in patients with acute myocardial infarction. J Cardiol 2009; 53:58-64. [DOI: 10.1016/j.jjcc.2008.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 08/21/2008] [Accepted: 08/25/2008] [Indexed: 01/08/2023]
|