The effect of atorvastatin treatment duration on oxidative stress markers and lipid profile in patients with coronary artery diseases: A case series study

Gholamreza Shahsavari, Amir Raoufi, Aram Toolabi, Nahid Hosseninejadmir, Hassan Ahmadvand, Mehdi Safariebrahimsarabie


BACKGROUND: The major aim of this study was evaluating the effect of atorvastatin treatment on thiobarbituric acid reactive substances (TBARS), ferric reducing the ability of plasma (FRAP), small dense low-density lipoprotein cholesterol (sdLDL) and lipid profile in coronary artery disease (CAD) patients.

METHODS: This study was carried out on 83 patients with angiographically proven coronary artery stenosis (52 men and 31 women) at Shahid Madani Hospital, Khorramabad, Iran, in 2015. The patients were divided into the 3 groups. 27 patients were classified statins consumption less than 6 days, 28 patients for 6 to 90 days, and 28 patients for more than 90 days. The level of sdLDL, lipid profile, TBARS and FRAP were assayed.

RESULTS: FRAP levels of patients that received atorvastatin for more than 90 days (832 ± 101) were significantly elevated (P = 0.01) compared to the patients received atorvastatin less than 6 days (688 ± 75), whereas the levels of TBARS diminished significantly (P = 0.04). Also, the levels of total cholesterol (TC) and LDL-C were significantly decreased after 3 months of atorvastatin receiving (158 as compared to patients that consumed atorvastatin less than 6 days), (P = 0.02 and 0.03, respectively). The level of sdLDL was slightly increased with long-time consumption of atorvastatin (37 ± 14) in patients in comparison with patients that received atorvastatin less than 6 days (32 ± 15) (P = 0.06), but was not significant.

CONCLUSION: The serum level of TBARS decreased and the serum level of FRAP increased in patients with long-time receiving atorvastatin. Therefore, atorvastatin contributes to the lowering oxidative stress in these patients.



Atorvastatin; Coronary Artery Disease; Oxidative Stress

Full Text:



Favero G, Paganelli C, Buffoli B, Rodella LF, Rezzani R. Endothelium and its alterations in cardiovascular diseases: life style intervention. Biomed Res Int 2014; 2014: 801896.

Liu Q, Wang S, Cai L. Diabetic cardiomyopathy and its mechanisms: Role of oxidative stress and damage. J Diabetes Investig 2014; 5(6): 623-34.

Ahmadvand H, Mabuchi H, Nohara A, Kobayahi J, Kawashiri MA. Effects of coenzyme Q(10) on LDL oxidation in vitro. Acta Med Iran 2013; 51(1): 12-8.

Ahmadvand H, Noori A, Dehnoo MG, Bagheri S, Cheraghi RA. Hypoglycemic, hypolipidemic and antiatherogenic effects of oleuropein in alloxan-induced Type 1 diabetic rats. Asian Pac J Trop Dis 2014; 4(Supplement 1): S421-S425.

Berneis KK, Krauss RM. Metabolic origins and clinical significance of LDL heterogeneity. J Lipid Res 2002; 43(9): 1363-79.

Kwon SW, Yoon SJ, Kang TS, Kwon HM, Kim JH, Rhee J, et al. Significance of small dense low-density lipoprotein as a risk factor for coronary artery disease and acute coronary syndrome. Yonsei Med J 2006; 47(3): 405-14.

Hirano T, Ito Y, Koba S, Toyoda M, Ikejiri A, Saegusa H, et al. Clinical significance of small dense low-density lipoprotein cholesterol levels determined by the simple precipitation method. Arterioscler Thromb Vasc Biol 2004; 24(3): 558-63.

Singh N, Singh N, Kumar SS, Kumar SA, Kafle D, Agrawal N. Reduced antioxidant potential of LDL is associated with increased susceptibility to LDL peroxidation in type II diabetic patients. Int J Endocrinol Metab 2012; 10(4): 582-6.

Packard CJ. Triacylglycerol-rich lipoproteins and the generation of small, dense low-density lipoprotein. Biochem Soc Trans 2003; 31(Pt 5): 1066-9.

Tian L, Li C, Liu Y, Chen Y, Fu M. The value and distribution of high-density lipoprotein subclass in patients with acute coronary syndrome. PLoS One 2014; 9(1): e85114.

Domingos H, Cunha RV, Paniago AM, Souza AS, Rodrigues RL, Domingos JA. Rosuvastatin and ciprofibrate in the treatment of dyslipidemia in patients with HIV. Arq Bras Cardiol 2012; 99(5): 997-1007.

Huang YC, Chang PY, Hwang JS, Ning HC. Association of small dense lowdensity lipoprotein cholesterol in type 2 diabetics with coronary artery disease. Biomed J 2014; 37(6): 375-9.

Llurba E, Casals E, Dominguez C, Delgado J, Mercade I, Crispi F, et al. Atherogenic lipoprotein subfraction profile in preeclamptic women with and without high triglycerides: different pathophysiologic subsets in preeclampsia. Metabolism 2005; 54(11): 1504-9.

Gentile M, Panico S, Mattiello A, Ubaldi S, Iannuzzo G, De Michele M, et al. Association between small dense LDL and early atherosclerosis in a sample of menopausal women. Clin Chim Acta 2013; 426: 1-5.

Nozue T, Michishita I, Ishibashi Y, Ito S, Iwaki T, Mizuguchi I, et al. Small dense low-density lipoprotein cholesterol is a useful marker of metabolic syndrome in patients with coronary artery disease. J Atheroscler Thromb 2007; 14(4): 202-7.

Liao JK, Laufs U. Pleiotropic effects of statins. Annu Rev Pharmacol Toxicol 2005; 45: 89-118.

Moutzouri E, Liberopoulos EN, Tellis CC, Milionis HJ, Tselepis AD, Elisaf MS. Comparison of the effect of simvastatin versus simvastatin/ezetimibe versus rosuvastatin on markers of inflammation and oxidative stress in subjects with hypercholesterolemia. Atherosclerosis 2013; 231(1): 8-14.

Davignon J, Jacob RF, Mason RP. The antioxidant effects of statins. Coron Artery Dis 2004; 15(5): 251-8.

Ahmadvand H, Tavafi M, Khosrowbeygi A, Shahsavari G, Hormozi M, Beyranvand K, et al. Amelioration of lipid peroxidation in vivo and in vitro by Satureja khozestanica essential oil in alloxan-induced diabetic rats. J Diabetes Metab Disord 2014; 13(1): 119.

Bolanos de la Torre AA, Henderson T, Nigam PS, Owusu-Apenten RK. A universally calibrated microplate ferric reducing antioxidant power (FRAP) assay for foods and applications to Manuka honey. Food Chem 2015; 174: 119-23.

Hirano T, Ito Y, Saegusa H, Yoshino G. A novel and simple method for quantification of small, dense LDL. J Lipid Res 2003; 44(11): 2193-201.

Ahmadvand H, Ghasemi-Dehnoo M. Antiatherogenic, hepatoprotective, and hypolipidemic effects of coenzyme Q10 in alloxan-induced type 1 diabetic rats. ARYA Atheroscler 2014; 10(4): 192-8.

Pandey KB, Rizvi SI. Biomarkers of oxidative stress in red blood cells. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155(2): 131-6.

Ahmadvand H, Tavafi M, Khosrowbeygi A. Amelioration of altered antioxidant enzymes activity and glomerulosclerosis by coenzyme Q10 in alloxan-induced diabetic rats. J Diabetes Complications 2012; 26(6): 476-82.

Majsterek I, Malinowska K, Stanczyk M, Kowalski M, Blaszczyk J, Kurowska AK, et al. Evaluation of oxidative stress markers in pathogenesis of primary open-angle glaucoma. Exp Mol Pathol 2011; 90(2): 231-7.

Singh U, Devaraj S, Jialal I, Siegel D. Comparison effect of atorvastatin (10 versus 80 mg) on biomarkers of inflammation and oxidative stress in subjects with metabolic syndrome. Am J Cardiol 2008; 102(3): 321-5.

Ky B, Burke A, Tsimikas S, Wolfe ML, Tadesse MG, Szapary PO, et al. The influence of pravastatin and atorvastatin on markers of oxidative stress in hypercholesterolemic humans. J Am Coll Cardiol 2008; 51(17): 1653-62.

Tavridou A, Efthimiadis A, Efthimiadis I, Paschalidou H. Antioxidant effects of simvastatin in primary and secondary prevention of coronary heart disease. Eur J Clin Pharmacol 2006; 62(6): 485-9.

Hsue PY, Bittner VA, Betteridge J, Fayyad R, Laskey R, Wenger NK, et al. Impact of female sex on lipid lowering, clinical outcomes, and adverse effects in atorvastatin trials. Am J Cardiol 2015; 115(4): 447-53.

Robertsen I, Asberg A, Granseth T, Vethe NT, Akhlaghi F, Ghareeb M, et al. More potent lipid-lowering effect by rosuvastatin compared with fluvastatin in everolimus-treated renal transplant recipients. Transplantation 2014; 97(12): 1266-71.

Yoshino G, Nakano S, Matsumoto T, Murakami E, Morita T, Kuboki K. Rosuvastatin Reduces Plasma Small Dense Ldl-Cholesterol Predominantly in Non-Diabetic Hypercholesterolemic Patients. Pharmacol Pharm 2012; 3(1): 72-8.

Nozue T, Michishita I, Ito Y, Hirano T. Effects of statin on small dense low-density lipoprotein cholesterol and remnant-like particle cholesterol in heterozygous familial hypercholesterolemia. J Atheroscler Thromb 2008; 15(3): 146-53.

Hosseini Gohari L, Karimzadeh Ghassab R, Firoozray M, Zavarehee A, Basiri HA. The association between small dense low density lipoprotein,apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio and coronary artery stenosis. Med J Islam Repub Iran 2009; 23(1): 8-13.

St-Pierre AC, Bergeron J, Pirro M, Cantin B, Dagenais GR, Despres JP, et al. Effect of plasma C-reactive protein levels in modulating the risk of coronary heart disease associated with small, dense, low-density lipoproteins in men (The Quebec Cardiovascular Study). Am J Cardiol 2003; 91(5): 555-8.

Nishikura T, Koba S, Yokota Y, Hirano T, Tsunoda F, Shoji M, et al. Elevated small dense low-density lipoprotein cholesterol as a predictor for future cardiovascular events in patients with stable coronary artery disease. J Atheroscler Thromb 2014; 21(8): 755-67.

Koh KK, Lim S, Choi H, Lee Y, Han SH, Lee K, et al. Combination pravastatin and valsartan treatment has additive beneficial effects to simultaneously improve both metabolic and cardiovascular phenotypes beyond that of monotherapy with either drug in patients with primary hypercholesterolemia. Diabetes 2013; 62(10): 3547-52.

Vega GL, Krauss RM, Grundy SM. Pravastatin therapy in primary moderate hypercholesterolaemia: changes in metabolism of apolipoprotein B-containing lipoproteins. J Intern Med 1990; 227(2): 81-94.



  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.