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Tursunova NV, Klinnikova MG, Babenko OA, Lushnikova EL. [Molecular mechanisms of the cardiotoxic action of anthracycline antibiotics and statin-induced cytoprotective reactions of cardiomyocytes]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2021; 66:357-371. [PMID: 33140729 DOI: 10.18097/pbmc20206605357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The manifestation of the side cardiotoxic effect of anthracycline antibiotics limits their use in the treatment of malignant processes in some patients. The review analyzes the main causes of the susceptibility of cardiomyocytes to the damaging effect of anthracyclines, primarily associated with an increase in the processes of free radical oxidation. Currently, research is widely carried out to find ways to reduce anthracycline cardiotoxicity, in particular, the use of cardioprotective agents in the complex treatment of tumors. Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) have been shown to improve the function and metabolism of the cardiovascular system under various pathological impacts, therefore, it is proposed to use them to reduce cardiotoxic complications of chemotherapy. Statins exhibit direct (hypolipidemic) and pleiotropic effects due to the blockade of mevalonic acid synthesis and downward biochemical cascades that determine their cardioprotective properties. The main point of intersection of the pharmacological activity of anthracyclines and statins is the ability of both to regulate the functioning of small GTPase from the Rho family, and their effect in this regard is the opposite. The influence of statins on the modification and membrane dislocation of Rho proteins mediates the indirect antioxidant, anti-inflammatory, endothelioprotective, antiapoptotic effect. The mechanism of statin inhibition of doxorubicin blockade of the DNA-topoisomerase complex, which may be important in preventing cardiotoxic damage during chemotherapy, is discussed. At the same time, it should be noted that the use of statins can be accompanied by adverse side effects: a provocation of increased insulin resistance and glucose tolerance, which often causes them to be canceled in patients with impaired carbohydrate metabolism, so further studies are needed here. The review also analyzes data on the antitumor effect of statins, their ability to sensitize the tumor to treatment with cytostatic drug. It has been shown that the relationship between anthracycline antibiotics and statins is characterized not only by antagonism, but also in some cases by synergism. Despite some adverse effects, statins are one of the most promising cardio- and vasoprotectors for use in anthracycline cardiomyopathy.
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Affiliation(s)
- N V Tursunova
- Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - M G Klinnikova
- Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - O A Babenko
- Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - E L Lushnikova
- Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
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Maulucci G, Cipriani F, Russo D, Casavecchia G, Di Staso C, Di Martino L, Ruggiero A, Di Biase M, Brunetti ND. Improved endothelial function after short-term therapy with evolocumab. J Clin Lipidol 2018; 12:669-673. [PMID: 29544724 DOI: 10.1016/j.jacl.2018.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The reduction of cholesterol levels with cholesterol-lowering therapy may improve endothelial function. Lipid-lowering therapy has been greatly enhanced by the introduction of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies. Less is known of the effect of PCSK9 inhibitors on endothelial function of subjects with hypercholesterolemia. OBJECTIVE To assess whether treatment with PCSK9 inhibitors may improve endothelial function evaluated by brachial artery vasoreactivity test. METHODS Brachial artery vasoreactivity test was performed in 14 consecutive patients with previous myocardial infarction before and after 2 months of therapy with evolocumab 140 mg twice in a month. Mean brachial artery diameter, velocity time integral, flow-mediated dilation (FMD) and low-density lipoprotein (LDL) cholesterol levels were also evaluated. RESULTS After 2 months of treatment with evolocumab, mean total cholesterol levels decreased from 245 ± 41 to 128 ± 30 mg/dL (P < .001, -48%), and LDL levels from 176 ± 43 to 71 ± 26 mg/dL (P = .001, -59%); FMD conversely increased from 6.3 ± 4.1% to 8.8 ± 6.3% (P = .004, +40%). Improvement in FMD was proportional to reduction of LDL levels (r = 0.69, P = .006). Therapy with evolocumab increased brachial artery diameter during vasoreactivity test (peak values 0.39 ± 0.09 vs 0.36 ± 0.11 cm, P = .010; final values 0.36 ± 0.10 vs 0.34 ± 0.10 cm, P = .001), and velocity time integral (peak levels 96 ± 1 vs 85 ± 9 cm, P = .045). CONCLUSIONS Two months of treatment with evolocumab 140 mg may improve endothelial function in subjects with increased cardiovascular risk. The improvement in endothelial function is proportional to LDL reduction.
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Affiliation(s)
| | - Francesco Cipriani
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
| | - Dolores Russo
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
| | | | | | - Luigi Di Martino
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Matteo Di Biase
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
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Akunne OO, Godman B, Adedapo AD, Truter I, Fadare J. Statin prescribing among hypertensive patients in southwest Nigeria: findings and implications for the future. J Comp Eff Res 2016; 5:281-8. [DOI: 10.2217/cer.15.65] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Statins reduce cardiovascular risk, especially in patients with hypertension due to their concomitant blood pressure reducing effects. Prescribing generic statins minimizes cost and improves access. Aims: Ascertain current prescribing of statins in Nigeria and potential savings from the increased use of generic statins. Methods: Prospective study involving hypertensive patients attending University College Hospital (Ibadan, Nigeria). Results: In total, 228 hypertensive patients received statins. Atorvastatin was the most prescribed statin, followed by simvastatin, rosuvastatin and finally fluvastatin. Prescribed doses were less than one defined daily dose in the majority, with high use of originators. Average monthly potential savings from increased prescribing of generic statins was US$2635 for atorvastatin and US$10,578 for rosuvastatin. Conclusion: A shift toward increased prescribing generic statins is recommended to minimize costs.
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Affiliation(s)
| | - Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | | | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela Metropolitan University, Port Elizabeth 6031, South Africa
| | - Joseph Fadare
- Department of Pharmacology, Ekiti State University, Ado-Ekiti, Nigeria
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Fassett RG, Robertson IK, Ball MJ, Geraghty DP, Coombes JS. Effects of atorvastatin on oxidative stress in chronic kidney disease. Nephrology (Carlton) 2015; 20:697-705. [DOI: 10.1111/nep.12502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Robert G Fassett
- School of Human Movement Studies; The University of Queensland; Brisbane Queensland Australia
| | - Iain K Robertson
- School of Human Life Sciences; University of Tasmania; Launceston Tasmania Australia
| | - Madeleine J Ball
- School of Human Life Sciences; University of Tasmania; Launceston Tasmania Australia
| | - Dominic P Geraghty
- School of Human Life Sciences; University of Tasmania; Launceston Tasmania Australia
| | - Jeff S Coombes
- School of Human Movement Studies; The University of Queensland; Brisbane Queensland Australia
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Wang Z, Yang X, Cai J, Shi H, Zhong G, Chi H. Vascular endothelial function of patients with stable coronary artery disease. Pak J Med Sci 2015; 31:538-42. [PMID: 26150839 PMCID: PMC4485266 DOI: 10.12669/pjms.313.6892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/15/2015] [Indexed: 11/15/2022] Open
Abstract
Objectives: To evaluate vascular endothelial function and contributing factors in coronary heart disease (CHD) patients. Methods: One hundred twenty six CHD outpatients were randomly recruited. Reactive hyperemia index (RHI) <1.67 indicates endothelial dysfunction. Correlation between RHI and different biochemical parameters was evaluated. Results: RHI in patients receiving statins treatment was significantly higher than patients without statins treatment (P<0.05). RHI in patients with more than 3 risk factors for CHD was also markedly lower than that in patients with ≤2 risk factors (P<0.05). Patients with lesions at several branches of coronary artery had a markedly lower RHI when compared with those with coronary lesions at a single branch (P<0.05). For patients without statins treatment, RHI increased significantly after statins treatment for 1 month (P=0.01). In patients with endothelial dysfunction, FBG, HbA1C, hs-CRP and Hcy were significantly higher than those in patients with normal endothelial function (P<0.05 for all). Smokers with CHD had a remarkably lower RHI when compared with non-smokers (P<0.05). Conclusions: Smoking, FBG, HbA1C, Hcy and hs-CRP are significantly associated with endothelial dysfunction. Endothelial dysfunction is also related to the numbers of risk factors for CHD, degree of coronary lesions and statins. Statins treatment may significantly improve the endothelial function of CHD patients.
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Affiliation(s)
- Zhe Wang
- Zhe Wang, MD. Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Xinchun Yang
- Xinchun Yang, MD. Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jun Cai
- Jun Cai, MD. Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Shi
- Hui Shi, MD. Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Guangzhen Zhong
- Guangzhen Zhong, MD, Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hongjie Chi
- Hongjie Chi, MD. Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Response to statin therapy in obstructive sleep apnea syndrome: a multicenter randomized controlled trial. Mediators Inflamm 2014; 2014:423120. [PMID: 25221387 PMCID: PMC4158472 DOI: 10.1155/2014/423120] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 07/23/2014] [Accepted: 07/25/2014] [Indexed: 01/12/2023] Open
Abstract
Rationale. Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA). Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA. Methods. This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint) measured by peripheral arterial tone (PAT). Secondary endpoints included office blood pressure (BP), early carotid atherosclerosis, arterial stiffness measured by pulse wave velocity (PWV), and metabolic parameters. Results. 51 severe OSA patients were randomized. Key demographics for the study population were age 54 ± 11 years, 21.6% female, and BMI 28.5 ± 4.5 kg/m2. In intention to treat analysis, mean PAT difference between atorvastatin and placebo groups was 0.008 (−0.29; 0.28), P = 0.979. Total and LDL cholesterol significantly improved with atorvastatin. Systolic BP significantly decreased with atorvastatin (mean difference: −6.34 mmHg (−12.68; −0.01), P = 0.050) whereas carotid atherosclerosis and PWV were unchanged compared to the placebo group. Conclusion. In OSA patients, 3 months of atorvastatin neither improved endothelial function nor reduced early signs of atherosclerosis although it lowered blood pressure and improved lipid profile. This trial is registered with NCT00669695.
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Gurovich AN, Avery JC, Holtgrieve NB, Braith RW. Flow-mediated dilation is associated with endothelial oxidative stress in human venous endothelial cells. Vasc Med 2014; 19:251-256. [PMID: 24916471 DOI: 10.1177/1358863x14537546] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Flow-mediated dilation (FMD) is recognized as a non-invasive endothelial function bioassay. However, FMD's relationship with endothelial cell oxidative stress in humans is yet to be determined. Here, we sought to determine if FMD was associated with endothelial nitric oxide synthase (eNOS) and endothelial oxidative stress in humans. Twenty-seven apparently healthy young men (26.5±5.9 years) underwent brachial artery FMD testing and endothelial cell biopsy from a forearm vein. Non-normalized FMD (%) and three different brachial artery FMD normalizations were performed: (1) peak shear rate (%/SR); (2) area under the SR curve until peak dilation (%/AUC); and (3) AUC 30 seconds before peak dilation (%/AUC30). Immunofluorescence quantification was used to assess eNOS expression and nitrotyrosine (NT), a criterion marker of endothelial oxidative stress. Values for eNOS and NT expression were reported as a ratio of endothelial cell to human umbilical vein endothelial cell average pixel intensity. NT expression was significantly correlated with FMD normalized by AUC30 (r = -0.402, p<0.05). Other FMD normalizations and non-normalized FMD were not significantly correlated with NT expression (r range = -0.364 to -0.142, all p>0.05). There were no significant correlations between eNOS expression and normalized and non-normalized FMD (r range = -0.168 to -0.066, all p>0.05). In conclusion, brachial artery FMD is associated with venous endothelial cell oxidative stress. However, this association is observed only when FMD is normalized by AUC30.
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Affiliation(s)
- Alvaro N Gurovich
- Indiana State University, Department of Applied Medicine and Rehabilitation, Terre Haute, IN, USA
| | - Joseph C Avery
- University of Florida, Department of Applied Physiology and Kinesiology, Center for Exercise Sciences, Gainesville, FL, USA
| | - Nicholas B Holtgrieve
- Indiana State University, Department of Applied Medicine and Rehabilitation, Terre Haute, IN, USA
| | - Randy W Braith
- University of Florida, Department of Applied Physiology and Kinesiology, Center for Exercise Sciences, Gainesville, FL, USA
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Banach M, Serban C, Aronow WS, Rysz J, Dragan S, Lerma EV, Apetrii M, Covic A. Lipid, blood pressure and kidney update 2013. Int Urol Nephrol 2014; 46:947-61. [PMID: 24573394 PMCID: PMC4012155 DOI: 10.1007/s11255-014-0657-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/28/2014] [Indexed: 12/24/2022]
Abstract
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland,
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Banach M, Nikfar S, Rahimi R, Bielecka-Dabrowa A, Pencina MJ, Mikhailidis DP, Narkiewicz K, Rysz J, Ray KK, Abdollahi M. The effects of statins on blood pressure in normotensive or hypertensive subjects--a meta-analysis of randomized controlled trials. Int J Cardiol 2013; 168:2816-24. [PMID: 23602289 DOI: 10.1016/j.ijcard.2013.03.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 02/26/2013] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to investigate whether statin therapy is associated with blood pressure (BP)-lowering in patients with or without hypertension. BACKGROUND The beneficial effects of statins on the cardiovascular system may in part be related to effects beyond lipid-lowering. It has been suggested that statins may reduce BP; however the available data are still ambiguous and often conflicting. METHODS Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for the years 1966-January 2012 were searched for studies that investigated the effect of statins on BP in normotensive or in hypertensive subjects. We included all randomized controlled clinical trials that investigated this effect. Changes in systolic and diastolic BP were the key outcomes of interest. RESULTS The final analysis included 18 trials and 5628 subjects (4692 normotensive and 936 hypertensive patients) randomized to receive either statins or placebo. The weighted mean difference of systolic (∆SBP) and diastolic blood pressure (∆DBP) in normotensive patients for the 11 statin trials included were 0.03 (95% CI: -0.95-1.02; p = 0.95) and -0.28 (95% CI: -0.80-0.24; p = 0.29), respectively. For hypertensive patients treated with statins (8 trials) the weighted mean difference of ∆SBP and ∆DBP were 1.45 (95% CI: -0.49-3.39; p = 0.14) and -1.32 (95% CI: -3.93-1.28; p = 0.32) respectively. CONCLUSIONS Despite previous suggestions statin therapy in normotensive or hypertensive patients does not lead to significant reductions in systolic or diastolic BP.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland.
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Rizos CV, Liberopoulos EN, Tellis CC, Tselepis AD, Elisaf MS. The effect of combining rosuvastatin with sartans of different peroxisome proliferator receptor-γ activating capacity on plasma 8-isoprostane prostaglandin F2a levels. Arch Med Sci 2013; 9:172-6. [PMID: 23515108 PMCID: PMC3598137 DOI: 10.5114/aoms.2013.33357] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 09/06/2012] [Accepted: 09/21/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Oxidative stress is associated with the development and progression of cardiovascular disease. Plasma 8-isoprostane prostaglandin F2a (8-iso-PGF2a) levels are a reliable marker of oxidative stress. MATERIAL AND METHODS Patients (n = 151) with hypertension, dyslipidemia and impaired fasting glucose were randomly allocated to rosuvastatin (10 mg/day) plus telmisartan 80 mg/day (RT group, n = 52) or irbesartan 300 mg/day (RI group, n = 48) or olmesartan 20 mg/day (RO group, n = 51). After 6 months of treatment, changes in plasma 8-iso-PGF2a levels were blindly evaluated. RESULTS A decrease of 8-iso-PGF2a levels vs baseline was observed only in the RT group (-8.6%; p = 0.02). A trend for decrease vs. baseline was observed in the RI (-5.7%; p = 0.40) and RO (-3.7%; p = 0.60) groups. Changes of 8-iso-PGF2a levels between groups were not significantly different (p = 0.70). CONCLUSIONS The combination of rosuvastatin with sartans of different peroxisome proliferator receptor-γ activating capacity was associated with a decrease in levels of plasma 8-iso-PGF2a. This decrease reached significance only in the telmisartan group.
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Affiliation(s)
- Christos V. Rizos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Greece
| | | | | | | | - Moses S. Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Greece
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Farah R, Jubran F, Khamisy-Farah R. Effects of statins on oxidative stress and primed polymorphonuclear leukocytes in hyperlipidemic patients. Biotech Histochem 2012; 87:519-25. [DOI: 10.3109/10520295.2012.719243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rizzo M, Montalto G, Banach M. The effects of statins on blood pressure: current knowledge and future perspectives. Arch Med Sci 2012; 8:1-3. [PMID: 22457664 PMCID: PMC3309426 DOI: 10.5114/aoms.2012.27270] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 01/27/2012] [Accepted: 01/29/2012] [Indexed: 11/17/2022] Open
Affiliation(s)
- Manfredi Rizzo
- Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
- Euro-Mediterranean Institute of Science and Technology, Italy
| | - Giuseppe Montalto
- Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
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