AbstractNon-alcoholic fatty liver disease is considered as an independent predictor of cardiovascular diseases which plays an important role in the development of ischemic heart disease. The drug most frequently used for treating this comorbidity is atorvastatin which favours better survival outcomes and is essential in the primary and secondary prevention of cardiovascular diseases. Ursodeoxycholic acid is prescribed as an alternative therapy for ischemic heart disease with co-existent non-alcoholic fatty liver disease and obesity to eliminate statin side effects. The use of ursodeoxycholic acid as a hepatoprotector in comprehensive basic treatment contributes to the improvement of the cardiovascular system in patients with ischemic heart disease as well as the increase in treatment efficacy; it improves the functional status of the liver affecting the major pathogenic mechanisms of the disease.The objective of the research was to study the effect of combined hypolipidemic therapy with atorvastatin and ursodeoxycholic acid on the indices of blood lipids, liver transaminase levels, functional status of the liver and the course of non-alcoholic fatty liver disease in patients with ischemic heart disease and obesity.Materials and methods. 20 patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity were examined. They received ursodeoxycholic acid in addition to atorvastatin for four weeks. All the patients underwent clinical tests, visceral ultrasonography, blood lipid test, liver transaminase test and 13C-methacetin breath test.Results. The study revealed a significant decrease in the level of the pro-atherogenic fractions of blood lipids (р<0.01) as well as an improved functional status of the liver due to a significant increase in metabolic capacity of the liver and cumulative dose on the 40th and 120th minutes after ursodeoxycholic acid administration (р<0.01).Conclusions. The use of ursodeoxycholic acid in addition to atorvastatin in patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity makes it possible to avoid the adverse effect of hypolipidemic therapy on the functional status of the liver.
Babak OYa, Kolesnikova EV. Nealkogolnaya zhirovaya bolezn pecheni i kardiovaskularnyy risk: sovremennyy vzglyad na problemu. Optimizatsiya terapii; Novosti meditsiny i farmatsii. 2012;8:33–38
Bazylevych AYa. Osoblyvosti perebihu ishemichnoii khvoroby sertsia u poiednanni z nealkoholnoiu zhyrovoiu khvoroboiu pechinky: mekhanizmy formuvannia, diahnostyka, optymizatsiia likuvannia, prohnoz [extended abstract of dissertation for Doctor of Medical Science]. Lviv: 2001. 30 p
Bazylevych AYa. Influence of ursodeoxycholic acid treatment upon ischemia and arrhythmia incidence, and autonomous nervous heart regulation in the patients with postinfarction cardiosclerosis after coronary arteries bypass graft combined with non-alcoholic fatty liver disease. Praktychna medytsyna. 2011;17(2):103–109
Virstyuk NG, Seniutovych NR. Diagnostic meaning of immunoreactive insulin, leptin and aldosterone in patients with non-alcoholic fat liver disease on the background of obesity. Galic’kij lìkars’kij vìsnik. 2010;17(4):15–16
Ivachevska VV, Chopey IV. Otsinka yakosti zhyttia patsientiv iz poiednanym perebihom nealkoholnoii zhyrovoii khvoroby pechinky ta stabilnymy formamy ishemichnoii khvoroby sertsia. Hastroenterolohiia. 2014;3:35–37
Kolesnikova EV. Nonalcoholicfatty liver disease and hypertension: what have we achieved in the understanding of the problem. Ukr med chasopys. 2014;3:61–66
Stepanov YuM, Abaturova OYe, Zavhorodnya NYu, Skyrda IYu. Non-alcoholic fatty liver disease in children: current view on diagnostics and treatment (part II). Hastroenterolohiia. 2015;3:99–107
Fadyeyenko GD, Solomentsev TA, Dovganiuk IE, Sitnik KA. Ranni oznaky aterosklerozy u khvoryk na nealkoholnu zhyrovy khvorobu pechinky. Suchsna hastroenterolohiia. 2014;4:32–37
Area M, Pigna G. Treating statin-intolerant patients. Diabets Metab Syndr Obes. 2011;4:155–166
Athyros VG, Tziomalos K, Gossios TD, et al. Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis. Lancet. 2010;376(9756):1916–1922. DOI: http://doi.org/10.1016/S0140-6736(10)61272-X
Carmelo AC, Gaspare MP, Angela A, et al. Cardiovascular risk factors, nonalcoholic fatty liver disease, and carotid artery intimamedia thickness in an adolescent population in southern Italy. Amer J Epidemiol. 2010;171(11):1195–1202. DOI: http://doi.org/10.1093/aje/kwq073
Nissen SE, Nicholls SJ, Sipahi I, et al. Effect of very high-intensity statin therapy on regression of coronary atherosclerosis; the ASTEROID trial. JAMA. 2006;295(13):583–584. DOI: http://doi.org/10.1001/jama.295.13.jpc60002
Gaspardone A, Area M. Atorvastatin: its clinical role in cerebrovascular prevention. Drugs. 2007;67(Suppl.1):55–62
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.