Improvement in endothelium dysfunction in diabetics treated with statins: a randomized comparison of atorvastatin 20 mg versus rosuvastatin 10 mg.
OBJECTIVE
To investigate the effect a 3-month treatment with atorvastatin 20 mg compared with rosuvastatin 10 mg on endothelium dysfunction in subjects with diabetes.


METHODS
A total of 22 consecutive subjects with diabetes who were not receiving statins were enrolled in the study. Endothelium function was assessed before treatment (T0), after 1 month (T1), and after 3 months of treatment (T2) with statins with brachial echo-Doppler test. Patients were randomized to receive atorvastatin 20 mg or rosuvastatin 10 mg. Blood samples were drawn in the meantime in order to evaluate C-reactive protein (CRP) plasmatic concentrations.


RESULTS
A total of 82% of patients enrolled showed endothelium dysfunction (hyperemic reserve <5%). Treatment with statins significantly improved endothelium function in diabetics. Subjects with endothelium dysfunction decreased from 82% (T0) to 44% (T2): mean hyperemic reserve values increased from 2.64% (T0) to 3.23% (T1) and 4% (T2) in patients treated with rosuvastatin (ANOVA P < 0.01), and from 2.74% (T0) to 2.75% (T1) and 4.40% (T2) in those treated with atorvastatin (ANOVA P < 0.01); differences were significant only comparing T2 with T0. Relative increase in endothelium reserve was 51.51% with rosuvastatin versus 60.58% with atorvastatin (P N.S.). Both statins significantly reduced plasmatic levels of CRP (3.18 +/- 2.43 mg/dL [T0] vs. 1.31 +/- 1.67 mg/dL [T2] with rosuvastatin [P < 0.01], 7.53 +/- 7.46 mg/dL [T0] vs. 2.92 +/- 2.06 mg/dL [T2] with atorvastatin [P < 0.01]). Relative reduction of CRP levels was -50.57% with rosuvastatin versus -36.28% with atorvastatin (P N.S.).


CONCLUSIONS
A 3-month treatment with either atorvastatin 20 mg or rosuvastatin 10 mg is effective in improving endothelium dysfunction in subjects with diabetes.
Cardiology Department, University of Foggia, Foggia, Italy. dr.natale.daniele.brunnetti@hotmail.it
Natale Daniele
ND
Brunetti
Guglielmo
G
Maulucci
Grazia Pia
GP
Casavecchia
Carlo
C
Distaso
Luisa
L
De Gennaro
Pier Luigi
PL
Pellegrino
Matteo
M
Di Biase
D000368:Aged; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage*; D011758:Pyrroles / Q000008:administration & dosage*; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*; D014664:Vasodilation / Q000187:drug effects*
D005464:Fluorobenzenes; D006538:Heptanoic Acids; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein; D000069059:Atorvastatin