eISSN: 2077-9135 / ISSN: 1681-5491
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Medical Channel Journal
2013, Volume 19, Issue 4 : 76-83
Research Article
Comparision of effects of atorvastatin and budesonide in reduction of cardiovascular risk in chronic obstructive pulmonary disease patients
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Department of Pharmacology, Jinnah Medical and Dental College, Karachi, Pakistan
Abstract

Background: The objective of this study is to demonstrating the duel cardiopulmonary protective effects of Atorvastatin in COPD patients, which may become the mainstay of therapy in prevention of exacerbation of COPD and cardiovascular events in COPD patients. Cardiovascular disease is a major cause of mortality and morbidity in COPD patients. Systemic inflammation plays a major role in the pathogenesis of cardiovascular disease in COPD. It has, therefore, been suggested that anti-inflammatory agents may prevent cardiovascular disease. it would be plausible that inhaled steroids, such as Budesonide, and by pleiotrophic effects of Atorvastatin can reduce the local inflammation and subsequent cardiovascular morbidity, thus a local effect on the lung resulting in diminished spill-over of inflammation systemically to the cardiovascular system is an attractive hypothesis. Objective: To assess the impact of Atorvastatin in reducing the cardiovascular risk in COPD patients and compare its effects with current anti-inflammatory agent (Steroids). Study design: Quasi experimental design. Place and Duration of Study: this study was 6 months (December 2010 to May 2011) with individual study period of 3 months (90 days), conducted in the Department of Pharmacology & Therapeutics in collaboration with Chest medicine JPMC Karachi. Methodology: 105 patients with moderate stable COPD, with hsCRP level >3mg/lit, were evaluated in an open label, intention to treat clinical trial. The patients were equally divided into 3 groups, Group A were assigned to give Tab. Atorvastatin, Group B were assigned to give Budesonide inhaler 200mcg BD and Group C were assigned to give combination of above therapy for 12 consecutive weeks. The primary study outcome was to evaluate the reduction in cardiovascular risk by evaluating the improvement in FEV1 and reduction in hsCRP levels, was evaluated at day 30, 60 and day 90. Results: 100 (96%) patients were completed the study. At day 0 there was no significant difference was noted between all treated groups. At day 90 all the parameters were further improved in all treated groups. The mean of hsCRP was 4.61 ± 0.19(28.5%) in Atorvastatin treated group whereas 5.82 ± 0.20(12.9%) in Budesonide treated group and 4.56 ±0.14 (29.2%) and there were highly significant difference were noted between the all treated groups and combination therapy was more effective in decreases the hsCRP. Conclusion: In conclusion, combination therapy of Atorvastatin with Budesonide effectively decrease the cardiovascular risk by decreasing the systemic inflammation which were indicated by decreasing the hsCRP levels and also improve pulmonary functional capacity in COPD patients.

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