Anti-inflammatory effects of rosuvastatin treatment in coronary artery ectasia patients in different age groups

Abstract Background: Coronary artery ectasia (CAE) is an angiographic finding of abnormal coronary dilatation. The role of inflammation in atherosclerosis is becoming increasingly well known. This study investigated the relationship between CAE and serum levels of high-sensitivity C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) to test our hypothesis that patient age is associated with the efficacy of anti-inflammatory therapy for CAE. Methods: We conducted a prospective analysis of 217 patients with CAE treated at the Department of Cardiology, Shanghai East Hospital, Shanghai East Hospital (Ji'an Campus), and Cardiovascular Medicine of Baoshan People’s Hospital of Yunnan Province, from January 1, 2015 to July 30, 2019. Baseline data of patients, including sex, age, hypertension, hyperlipidemia, and diabetes, were collected from patient medical records. Study participants were grouped by age as follows: CAE-A (age ≤50 years), CAE-B (50 years 70). Additionally, there was a normal control (NC) group with normal coronary arteries.Results: All patients received oral rosuvastatin therapy (10 mg, QN quaque nocte) when they were diagnosed with CAE and maintained good follow-up, with a loss rate of 0.0% at the 6-month follow-up. The NC group (n = 73, with normal coronary arteries) received regular symptom-relieving treatments and rosuvastatin therapy. Among these four groups, the inflammatory markers were significantly higher in patients with CAE than in the NCs (p<0.01). Logistic regression analysis showed that Hs-CRP (OR=1.782, 95% CI: 1.124-2.014, P=0.021) and IL-6 (OR=1.584, 95% CI: 1.112-1.986, P=0.030) were independent predictors of CAE. The inflammatory markers in the CAE-A group were higher than those in the CAE-B group, which were higher than those in the CAE-C group. Follow-up after 6 months of rosuvastatin therapy showed a significantly greater reduction in Hs-CRP and IL-6 levels in the CAE-A group than in the CAE-B group, which, again, were higher than those in the CAE-C group. Conclusions: Anti-inflammatory therapy using rosuvastatin was more effective in younger CAE patients, indicating the need for early statin therapy in CAE patients.