title: Cholesterol lowering is more important than pleiotropic effects of statins for endothelial function in patients with dysglycaemia and coronary artery disease.
abstract: OBJECTIVE
  The importance of pleiotropic effects of statins on endothelial function and inflammatory markers was investigated in patients with dysglycaemia and coronary artery disease (CAD).
  
  
  RESULTS
  Thirty-nine patients were randomized to simvastatin 80 mg daily (S80; n = 20) or ezetimibe 10 mg and simvastatin 10 mg daily (E10/S10; n = 19) for 6 weeks, aiming at similar cholesterol reduction. Endothelial function, evaluated by brachial artery flow-mediated vasodilatation (FMD) and the effect of endothelin receptor blockade, serum lipids, and inflammatory markers were evaluated at baseline and follow-up. At follow-up, low-density lipoprotein cholesterol decreased from 3.1 (2.8-3.4) (median and quartiles) to 1.5 mmol/L (1.4-1.7) and from 3.0 (2.5-3.4) to 1.3 mmol/L (1.1-1.8), in the S80 and E10/S10 groups, respectively. In the entire study group, FMD increased from 4.3% (3.4-6.1) at baseline to 5.5% (3.4-6.6) at follow-up, while C-reactive protein decreased from 3.1 (1.7-7.6) to 2.3 mg/L (0.9-6.5). The changes in FMD and C-reactive protein from baseline to follow-up were not significantly different between patients on S80 and E10/S10 groups. Endothelin blockade enhanced endothelium-dependent vasodilatation both at baseline and follow-up.
  
  
  CONCLUSIONS
  Lipid lowering is more important than pleiotropic effects of statins for improvement in endothelial function and inflammatory markers in patients with dysglycaemia and CAD.
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Stockholm SE-17176, Sweden. magnus.settergren@karolinska.se
authors.forename: Magnus
authors.initials: M
authors.lastname: Settergren
authors.forename: Felix
authors.initials: F
authors.lastname: Böhm
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.forename: John
authors.initials: J
authors.lastname: Pernow
mesh_terms: D000368:Aged; D001384:Azetidines / Q000494:pharmacology / Q000627:therapeutic use; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D000069438:Ezetimibe; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D012039:Regional Blood Flow / Q000187:drug effects; D019821:Simvastatin / Q000494:pharmacology / Q000627:therapeutic use; D014664:Vasodilation / Q000187:drug effects
chemical_list: D001384:Azetidines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D008055:Lipids; D002784:Cholesterol; D019821:Simvastatin; D000069438:Ezetimibe