title: Atorvastatin decreases elevated soluble CD40L in subjects at high cardiovascular risk. Atorvastatin on inflammatory markers study: a substudy of ACTFAST.
abstract: The CD40/CD40 ligand plays a role in the inflammatory and prothrombotic processes in atherosclerosis. We analyzed whether short-term treatment with atorvastatin affects soluble CD40 ligand (sCD40L) plasma levels in subjects at high cardiovascular risk. sCD40L plasma concentrations were measured in 852 subjects from the Atorvastatin on Inflammatory Markers (AIM) Study, a 12-week prospective multicenter, open-label trial which enrolled statin-free subjects with coronary heart disease (CHD), CHD-equivalent (diabetes, peripheral vascular disease, or cerebrovascular disease), or a 10-year CHD risk >20%. Subjects were assigned to atorvastatin (10-80 mg/day) based on LDL-C at screening. Overall, sCD40L levels were not different in patients at high cardiovascular risk compared with healthy subjects. When sCD40L levels were divided in quartiles, patients in the highest quartile (N=213) had higher sCD40L concentrations than age- and gender-matched healthy subjects (N=29) (P<0.0001). Interestingly, all doses of atorvastatin significantly diminished sCD40L levels in subjects at the highest quartile. Furthermore, atorvastatin treatment decreased sCD40L more markedly in subjects with metabolic syndrome compared with those without metabolic syndrome. In conclusion, atorvastatin diminishes sCD40L plasma levels, more markedly so in subjects with metabolic syndrome. Our results indicate that short-term treatment with atorvastatin exhibits anti-inflammatory and antithrombotic effects in subjects at high cardiovascular risk.
authors.affiliation: Vascular Research Lab. Fundación Jimenéz Díaz. Autonoma University, Madrid, Spain.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Blanco-Colio
authors.forename: Jose L
authors.initials: JL
authors.lastname: Martín-Ventura
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Teresa
authors.forename: Csaba
authors.initials: C
authors.lastname: Farsang
authors.forename: Allan
authors.initials: A
authors.lastname: Gaw
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gensini
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Leiter
authors.forename: Anatoly
authors.initials: A
authors.lastname: Langer
authors.forename: Pierre
authors.initials: P
authors.lastname: Martineau
authors.forename: Jesús
authors.initials: J
authors.lastname: Egido
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D023201:CD40 Ligand / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000494:pharmacology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D014280:Triglycerides; D023201:CD40 Ligand; D002097:C-Reactive Protein; D000069059:Atorvastatin