title: The effects of atorvastatin on coronary endothelial function in patients with recent myocardial infarction.
abstract: 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.
authors.affiliation: Division of Cardiology, Tokushima Red Cross Hospital, Komatsushima-city, Tokushima, Japan. hoso@tokushima-med.jrc.or.jp
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tomokane
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohara
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ogata
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yuba
authors.forename: Naoki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohtani
mesh_terms: 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
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D000109:Acetylcholine