Fluvastatin treatment and withdrawal: effects on endothelial function.
Fluvastatin lowers lipids and protects endothelial function. This study investigated how 2 preparations of fluvastatin would affect endothelial function after treatment and early after its discontinuation. Twenty-seven patients received 80 mg extended-release fluvastatin every day, 40 mg immediate-release fluvastatin twice a day, or placebo for 5 weeks. Fasting lipids and flow-mediated dilation were measured at baseline and after each treatment period. In 21 patients, flow-mediated vasodilation was also measured 24 hours after discontinuation of therapy. Both forms of fluvastatin improved flow-mediated vasodilation (extended release: P < .037 and immediate release: P < .001). However, this improvement occurred preferentially in patients with low baseline flow-mediated vasodilation (<5%). Twenty-four hours after treatment discontinuation, the flow-mediated vasodilation deteriorated again to baseline (extended release and immediate release: P < .001). Fluvastatin improved flow-mediated vasodilation only in patients with low baseline values. Twenty-four hours after discontinuation, the flow-mediated vasodilation deteriorated again, surprisingly irrespective of prior improvement.
Westphal
Sabine
S
Institute of Clinical Chemistry and Pathobiochemistry, Magdeburg University Hospital. Sabine.Westphal@Medizin.Uni-Magdeburg.de
Abletshauser
Claudia
C
Luley
Claus
C
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007211:Indoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000187:drug effects; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003692:Delayed-Action Preparations; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D014280:Triglycerides; D000077340:Fluvastatin