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Article A novel hypothesis of atherosclerosis: EPCs-mediated repair-to-injury. 2008
Zhang M, Zhou SH, Li XP, Shen XQ, Fang ZF. · Department of Cardiology, Second Xiangya Hospital, Central South University, Changsha Hunan 410011, China. · Med Hypotheses. · Pubmed #17920780 No free full text.
Abstract: Recent findings demonstrate the vital role of endothelial progenitor cells in the homeostasis of the vessel wall and the development of atherosclerosis. Endothelial progenitor cells (EPCs) play important roles in repair-to-injury of arteries. Many evidences have shown Cardiovascular risk factors closely correlated with EPCs numbers and function. Levels of circulating EPCs represented a better predictor of endothelial function than conventional risk factors. Depletion of bone marrow and Cardiovascular risk factors are the two prerequisits of atherosclerosis. All conditions of manifest atherosclerotic disease are accompanied by reduced EPC numbers and migratory capacity. Therefore, based on response-to-injury hypothesis and these findings, we build up EPCs-mediated repair-to-injury hypothesis, which may have important therapeutic implications in the prevention and therapy of atherosclerosis. The use of EPCs for vascular repair may be important therapy strategies with a maximized benefit for the patient in the future.
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Article [Efficacy and safety of extended-release niacin alone or with atorvastatin for lipid profile modification] 2006
Li XP, Duan J, Zhao SP, Tan MY, Xu ZM, Zhang DQ. · Department of Cardiology, Second Xiangya Hospital of Central-South University, Changsha, China. · Zhonghua Yi Xue Za Zhi. · Pubmed #17156651 No free full text.
Abstract: OBJECTIVE: To evaluate the efficacy and safety of extended-release niacin (niacin ER) either alone or in combination with atorvastatin for the lipid profile modification in the patients with coronary heart disease (CHD) and its equivalents. METHODS: One hundred and ten patients with CHD and its equivalents with serum total cholesterol (TC) > or = 3.5 mmol/L were randomly assigned into three treatment groups: (1) atorvastatin group (n = 38), receiving atorvastatin 10 mg/d for 8 weeks; (2) niacin ER group (n = 38), given niacin ER 500 mg/d for 4 weeks and then 1000 mg/d for 4 weeks; (3) combination treatment group (n = 34), treated with atorvastatin (10 mg/d) plus niacin ER, with the dose initiating from 500 mg/d, and increasing to 1000 mg/d after 4 weeks, for 8 weeks. The serums lipid profiles and adverse effects were assessed in all the patients before treatment, and 4 and 8 weeks after treatment. RESULTS: (1) After 8 weeks of treatment, the serum level of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were reduced by 30% and 16% respectively in the niacin ER group compared with the baseline values (both P < 0.05). After 8 weeks, the TC, low-density lipoprotein cholesterol (LDL-C), and TG in the atorvastatin group decreased by 19%, 26%, and 17% respectively compared with the baseline values (all P < 0.05). Combination treatment decreased the TC, LDL-C, and TG levels by 28%, 38%, and 39% respectively, and increased the HDL-C level by 23% (all P < 0.05). The improvement in TC and LDL-C achieved by combination treatment was superior to treatment of atorvastatin alone and treatment of niacin ER alone (all P < 0.05). (2) The rate of achieving the LDL-C goal of The National Cholesterol Education Program (NCEP) in Adult Treatment Panel III (ATP III) in the combination therapy group was 73.5%, significantly higher than those of the atorvastatin and niacin groups (47.7% and 42.1% respectively, both P < 0.05). (3) Adverse effect, such as flushing (15.8%) and gastrointestinal symptoms (23.7%) were found in the niacin ER group, however, no more adverse effects were found in the combination therapy group. There were no serious adverse events in all groups. CONCLUSION: Niacin ER has a favorable effect in modulating the blood lipid profile, especially in reducing TG and elevating HDL-C. Combined statin with niacin may produce a more global and effective improvement in lipid blood levels than monotherapy and is generally safe and well tolerable.
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