The effects of atorvastatin on coronary endothelial function in patients with recent myocardial infarction.
BACKGROUND
Endothelial dysfunction is a key early event in atherosclerosis that occurs in acute coronary syndrome. It was reported that atorvastatin improves the endothelial function of skeletal muscle vessels, but the effect on the coronary artery is unknown.


OBJECTIVE
The purpose of this study is to determine the effects of atorvastatin on coronary endothelial function in humans.


METHODS
Non-infarct-related coronary arteries of 48 patients with acute myocardial infarction who had undergone successful percutaneous transluminal coronary angioplasty were examined. Three groups were studied: hyperlipidemia with use of atorvastatin (Group 1, n=17), hyperlipidemia without statin use (Group 2, n=18), and normal cholesterol level controls (Group 3, n=13). Statin treatment was started at discharge. Acetylcholine (Ach) was infused into the coronary artery and the diameter was assessed by quantitative angiography at baseline and after 6 months.


RESULTS
Acetylcholine given in doses of 1, 3, 10, and 30 mg/min increased the coronary artery diameter change in a dose-dependent manner. In the initial study, patients in the three groups had similar responses to Ach. The mean diameter change after 6 months was significantly improved in Group 1 compared with Groups 2 and 3 (-11 +/- 3% vs. -20 +/- 7% and -21 +/- 6%, respectively; p < 0.01 in each case). Multivariate regression analysis showed that atorvastatin (p < 0.01) was the significant determinant for improvement of endothelial function.


CONCLUSIONS
These findings suggest that atorvastatin improves endothelial function of the coronary artery in patients with myocardial infarction.
Hosokawa
Shinobu
S
Division of Cardiology, Tokushima Red Cross Hospital, Komatsushima-city, Tokushima, Japan. hoso@tokushima-med.jrc.or.jp
Hiasa
Yoshikazu
Y
Tomokane
Takeshi
T
Ogura
Riyo
R
Miyajima
Hitoshi
H
Ohara
Yoshikazu
Y
Ogata
Tatsuro
T
Yuba
Kenichiro
K
Suzuki
Naoki
N
Takahashi
Takefumi
T
Kishi
Koichi
K
Ohtani
Ryuji
R
D000109:Acetylcholine; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000187:drug effects* / Q000473:pathology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D012044:Regression Analysis; D013997:Time Factors
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D000109:Acetylcholine