title: Simvastatin treatment improves endothelial function and increases fibrinolysis in patients with hypercholestrolemia.
abstract: OBJECTIVE
  Statins reduce cardiovascular events by cholesterol-lowering as well as nonlipid-related actions. Thrombin activatable fibrinolysis inhibitor (TAFI) is a recently identified independent risk factor of thrombosis. Endothelial dysfunction is also a strong predictor of cardiovascular events. The aim of this study was to assess the effects of simvastatin treatment on circulating TAFI concentrations and endothelial function in patients with hypercholesterolemia.
  
  
  METHODS
  Thirty-five patients (19 female, mean age 48 +/- 7 years) with hyperlipidemia were recruited into the study. Simvastatin was administered, 40 mg daily, for eight weeks to all subjects. Study subjects did not receive any medication except for lipid-lowering therapy during the follow-up period. Endothelial function was evaluated by flow-mediated dilation (FMD) from the brachial artery of the patients. Plasma lipid parameters, TAFI levels and endothelial function were measured before and after simvastatin treatment.
  
  
  RESULTS
  Treatment with simvastatin showed a significant decrement in plasma total cholesterol, LDL cholesterol and triglyceride levels (p<0.05). Plasma TAFI levels were also significantly decreased after simvastatin treatment [median 17.0 (range 0.4-93.7) mcg/mL versus median 6.9 (range 0.8-63.0) mcg/mL, p<0.001]. Mean FMD was measured 7.7 +/- 2.5% at baseline and significantly improved after treatment (13.0 +/- 1.4%) (p=0.001).
  
  
  CONCLUSIONS
  Our findings of decreased TAFI levels may reflect the beneficial effect of simvastatin treatment on fibrinolysis, and improved endothelial function may suggest the improved future cardiovascular events in hyperlipidemic patients.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey.
authors.forename: Gulay S
authors.initials: GS
authors.lastname: Guven
authors.forename: Enver
authors.initials: E
authors.lastname: Atalar
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Yavuz
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Beyazit
authors.forename: Murat
authors.initials: M
authors.lastname: Kekilli
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kilicarslan
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Gul
authors.initials: G
authors.lastname: Oz
authors.forename: Necla
authors.initials: N
authors.lastname: Ozer
authors.forename: Serdar
authors.initials: S
authors.lastname: Aksoyek
authors.forename: Ibrahim C
authors.initials: IC
authors.lastname: Haznedaroglu
authors.forename: Tumay
authors.initials: T
authors.lastname: Sozen
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019821:Simvastatin / Q000627:therapeutic use*
chemical_list: D000924:Anticholesteremic Agents; D019821:Simvastatin