The early effect of lipid-lowering treatment on carotid and femoral intima media thickness (IMT).
OBJECTIVE
an increased intima media thickness (IMT) is an early indicator of the atherosclerotic process. We investigated the early effect of atorvastatin on the common carotid artery (CCA) and common femoral artery (CFA) IMT.


METHODS
the IMT was measured in the CCA and the CFA of hyperlipidaemic patients referred with peripheral vascular disease. The measurements were performed using an automated radio frequency IMT technique pre-treatment and at 4 and 8 weeks post-treatment with 20 mg/day atorvastatin.


RESULTS
patients (14 men; 11 women), median age 69 years (range: 48-81) had a CCA-IMT mean (SD) of 0.79 (0.21) mm pre-treatment, 0.75 (0.22) mm after 4 weeks, and 0.64 (0.15) mm after 8 weeks. The ANOVA test was significant (p=0.024) for the CCA-IMT trend. The corresponding CFA-IMT readings were 0.83 (0.13) mm, 0.80 (0.09) mm and 0.69 (0.14) mm (p=0.0003). After 8 weeks of treatment there was a significant reduction in total cholesterol 6.0 (0.3) to 4.3 (0.8) mmol/l, p=0.0004 and low-density lipoprotein cholesterol 3.7 (0.2) to 2.2 (0.5), p=0.0001. There was a significant decrease in median serum creatinine levels after 8 weeks treatment: 87 micromol/l (range 67-114) to 84 micromol/l (range: 64-112), p=0.007.


CONCLUSIONS
cholesterol-lowering with atorvastatin 20 mg/day leads to a decrease in CCA-IMT and CFA-IMT. This difference achieved significance after 8 weeks of treatment, but a trend was visible at 4 weeks. These rapid changes in IMT may be attributable to an anti-inflammatory effect. IMT measurement may be a useful tool to rapidly assess the effect of drug treatment on the atherosclerotic process.
Youssef
F
F
University Department of Surgery, Royal Free Hospital NHS Trust and Royal Free and University College Medical School, University College London, UK.
Seifalian
A M
AM
Jagroop
I A
IA
Myint
F
F
Baker
D
D
Mikhailidis
D P
DP
Hamilton
G
G
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D000069059:Atorvastatin; D017536:Carotid Artery, Common / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005263:Femoral Artery / Q000187:drug effects / Q000473:pathology*; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000494:pharmacology*; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin