The efficacy of Rosuvastatin in elderly patients with coronary heart disease on the background of acute respiratory viral infection with various polymorphic variants of interleukin genes

Abstract

Background: Coronary heart disease (CHD) is the leading pathology among all cardiovascular diseases. Elderly patients with concomitant diseases represent a special risk group. Acute respiratory viral infections (ARVI) in old age tend to be more severe due to age-related immunodeficiency. There are known facts of the negative influence of viruses and bacteria on the course of atherosclerosis, manifested increase in the frequency of angina attacks, changes in the level of inflammatory markers. At the same time, lipid metabolism disorders in the elderly category of patients require a change in the approaches to therapy. The aim of the study: To analyze the association of interleukin genes with a dose choice of rosuvastatin in patients with CHD and ARVI in comparison with patients without an infectious process. Materials and methods: The study included 118 men and women aged 61-74 years with coronary artery disease, among them 63 people were in comorbidity with ARVI and 55 were without ARVI. The lipid spectrum and immune profile were determined (interleukins (IL-1β, IL-6, IL-4, IL-10)), genotyping of interleukin genes (IL-1β, IL-4, IL-6, IL-10). We used Microsoft Excel 2010 and Statistika 7 for Windows, SNPStats. Results: The selection of the correct dose of rosuvastatin for plaque protection in acute infection is based on correlation with the genotypes of interleukin genes. The association of the genotypes of proinflammatory IL-1β manifested itself in the achievement of the target LDL cholesterol by patients with the – 511CT genotype for the –511C>T (rs16944) polymorphism when taking rosuvastatin 20 Оригинальная статья Original article Грибовская ИА, и др. Эффективность розувастатина у пожилых ... Gribovskaya IA, et al. The efficacy of Rosuvastatin in elderly patients ... 412 mg/day in comparison with other genotypes. Homozygotes C/C-T/T showed a pronounced drug response, manifested by the achievement of the target level of LDL cholesterol with the appointment of 10 mg rosuvastatin. For carriers of other variants of genotypes for polymorphism –174G/C (rs1800795) IL-6, –589C>T (rs2243250) IL-4 and –1082G>A (rs1800896) IL-10, there was a statistically significant relationship with the dose regimen of rosuvastatin in patients with coronary artery disease in conditions of viral infection were not observed. There were no associations between the statin therapy regimen with interleukin genotypes (IL-1β, IL-6, IL-4, IL-10) in elderly patients with coronary artery disease without an infectious process (p>0.05). Conclusion: Genotyping of interleukin genes can be used for a personalized approach to the pharmacotherapy of hyperlipidemia (GLP) in elderly patients with CHD, provided concomitant ARVI.