Abstract 533 High-dose atorvastatin improves endothelial function, arterial vascular  elasticity and carotid wall structure in patients with advanced coronary artery disease, hyperlipidemia and diabetes mellitus type IIa    

Z Kardiol 94: Suppl 2 (2005)
High-dose atorvastatin improves endothelial function, arterial vascular elasticity and carotid wall structure in patients with advanced coronary artery disease, hyperlipidemia and diabetes mellitus type IIa
P. Klein¹, T. Dill², A. Peil², O. Ekinci², J. Hansel², A. Berkowitsch², C. W. Hamm², V. Mitrovic²
¹, Hilzingen; ²Kerckhoff Klinik GmbH, Bad Nauheim;
Hypothesis: Previous trials have shown that atorvastatin (Sortis®) improves endothelial function by reducing total cholesterol and cytokin profile. Purpose of the present study was to analyze the effects of atorvastatin 40 mg daily on laboratory parameters, endothelial function, arterial vascular elasticity, carotid wall structure and myocardial perfusion in patients with coronary artery disease and hyperlipidemia prior to and after a six-months therapy. Methods: In this open, baseline-controlled, single center study, 15 patients (10 male/5 female, mean age 62.3±7.5 years) were enrolled. Analysis of endothelial function was performed by measurement of changes of blood flow using venous occlusion plethysmography (left brachial artery) prior to/after intra arterial administration of acetylcholine (20µg/40µg) and sodium nitroprusside (4µg/8µg). Vascular elasticity of large/small vessels was measured by use of HDI/Pulse Wave TM CR-2000. Carotid wall and myocardial perfusion were assessed by MRI/1,5 Tesla System, Sonata Siemens. Results: Six months after treatment with 40 mg atorvastatin a reduction of total cholesterol (236±46 vs 158±25 mg/dl, p<0.001), triglycerides (264±68 vs 153±58 mg/dl, p<0.001), LDL-cholesterol (138±15 vs 69±31 mg/dl, p<0.001), apo-lip B (109±28 vs 62±22 mg/dl, p=0.001), interleukin-6 (3.8±2.2 vs 1.36±1.2 pg/ml, p<0.001) and hs-CRP (2,97±2,3 vs. 1,17±1,36, n=3, p=0.01) was observed. Blood flow at rest was improved by 75% (p<0.001) after administration of acetylcholine (20µg/40µg) and vascular elasticity of the large vessels (16±3,7 vs 23±9,9 ml/mmHg 10, p<0.04) increased. Plaque area decreased by 0.13 cm² (-25%, p<0.001) and analysis of quantitative myocardial perfusion indicated a positive trend. Conclusion:* The present study showed that administration of high-dose atorvastatin over a period of 6 months improved laboratory parameters, endothelial function, arterial vascular elasticity and carotid wall structure in patients with coronary artery disease, hyperlipidemia and diabetes type IIa.
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