Atorvastatin therapy improves exercise oxygen uptake kinetics in post-myocardial infarction patients.
BACKGROUND
Statins represent a modern mainstay of the drug treatment of coronary artery disease and acute coronary syndromes. Reduced aerobic work performance and slowed VO(2) kinetics are established features of the clinical picture of post-myocardial infarction (MI) patients. We tested the hypothesis that statin therapy improves VO(2) exercise performance in normocholesterolaemic post-MI patients.


METHODS
According to a double-blinded, randomized, crossover and placebo-controlled study design, in 18 patients with uncomplicated recent (3 days) MI we investigated the effects of atorvastatin (20 mg day(-1)) on gas exchange kinetics by calculating VO(2) effective time constant (tau) during a 50-watt constant workload exercise, brachial artery flow-mediated dilatation (FMD) as an index of endothelial function, left ventricular function (echocardiography) and C-reactive protein (CRP, as an index of inflammation). Atorvastatin or placebo was given for 3 months each.


RESULTS
Atorvastatin therapy significantly improved exercise VO(2) tau and FMD, and reduced CRP levels. We did not observe changes in cardiac contractile function and relaxation properties during all study periods in either group.


CONCLUSIONS
In post-MI patients exercise performance is a potential additional target of benefits related to statin therapy. Endothelial function improvement is very likely implicated in this newly described therapeutic property.
Guazzi
M
M
Cardiopulmonary Unit, Cardiology Division, University of Milan, San Paolo Hospital, 20142 Milan, Italy. marco.guazzi@unimi.it
Tumminello
G
G
Reina
G
G
Vicenzi
M
M
Guazzi
M D
MD
D000924:Anticholesteremic Agents / Q000097:blood / Q000627:therapeutic use*; D000069059:Atorvastatin; D003324:Coronary Artery Disease; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006538:Heptanoic Acids / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000378:metabolism; D010101:Oxygen Consumption; D011758:Pyrroles / Q000097:blood / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin