Effects of low-dose atorvastatin on vascular responses in patients undergoing percutaneous coronary intervention with stenting.
BACKGROUND
The primary endpoint of this study was to evaluate the effects of low-dose atorvastatin on carotid intima-media thickness (IMT) and endothelial function, and the secondary endpoint comprised restenosis and target lesion revascularization (TLR) in patients undergoing percutaneous coronary intervention (PCI) with stenting for the treatment of coronary artery disease.


METHODS
Two hundred five consecutive patients (mean age, 60 years) undergoing PCI were prospectively randomized to usual therapy (control group, n = 100) or to 10 mg of atorvastatin daily plus usual therapy (statin group, n = 105). Carotid IMT, endothelial function (flow-mediated dilatation [FMD] of the brachial artery), and coronary angiograms were taken before the study and 6 months after randomization. The 6-month follow-up measurements of the above factors were obtained in 83 patients (83%) of the control group and in 97 patients (92%) of the statin group.


RESULTS
No significant differences were noted in the baseline clinical and angiographic findings in either group. FMD was significantly improved during the 6 months in the statin group (4.38% +/- 1.7% vs 4.85% +/- 1.6%, P = .003), but did not change in the control group. Carotid IMT did not show any significant changes at 6 months in either group. There was a trend in favor of statin in terms of restenosis rate (26.8% vs 36.1%, P = .177) and TLR rate (18.6% vs 25.3%, P = .274). The changes of FMD were significantly correlated with the changes of total cholesterol and the changes of low-density lipoprotein, respectively (r = -0.336, P = .009, and r = -0.310, P = .046).


CONCLUSIONS
Low-dose atorvastatin reduces endothelial dysfunction as measured by FMD, which coincides with the beneficial effects on lipid profiles, and can decrease restenosis and TLR rate in patients undergoing PCI with stenting.
Bae
Jang-Ho
JH
Division of Cardiology, College of Medicine, Konyang University Hospital, Daejeon, South Korea. jhbae@kyuh.co.kr
Bassenge
Eberhard
E
Kim
Ki-Young
KY
Synn
Yi-Chul
YC
Park
Ki-Rack
KR
Schwemmer
Michael
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D015607:Stents; D014463:Ultrasonography
D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin