Atorvastatin therapy is associated with improvement of oxidized low-density lipoprotein cholesterol levels, which correlates with the degree of stenosis in patients with carotid atheromatosis with and without prior angioplasty.
OBJECTIVE
Oxidized low-density lipoprotein (oxLDL) is a pivotal factor of the atheromatous process. Statins reduce atheromatosis and cardiovascular risk. The aim of the present study was to investigate the effect of statin therapy on circulating oxLDL and the possible impact of such effect on stenosis due to carotid artery atheromatosis.


METHODS
A total of 100 patients (76 males, median age 68 years) with carotid atheromatosis were enrolled. Those with stenosis >70% (n=50) were pre-treated with carotid angioplasty, whereas those with <70% were treated conservatively. Both groups were given low-dose atrorvastatin, tittered to maintain LDL cholesterol <100 mg/dL. Anthropometrics, complete lipid profile, and oxLDL were obtained in 1, 3, 6 and 12 months. Stenosis was evaluated by ultrasonography at baseline and 12 months.


RESULTS
Lipid profile significantly improved at 12 months and oxLDL fell from 62.26+/-22.03 mg/dL at baseline to 44.49+/-21.75 mg/dL at 12 months (P<0.001). In the invasively pretreated group no restenosis was noticed; in the conservatively treated group a significant reduction of stenosis was demonstrated (47.6+/-13.2% vs 37.7+/-15.7%, P<0.001). The decrease of oxLDL correlated with the reduction of stenosis (r=0.17, P=0.018). In multivariate analysis, oxLDL was an independent risk factor for re-stenosis (hazard ratio=4.319, P<0.001).


CONCLUSIONS
A marked reduction of oxLDL was shown in patients with carotid atheromatosis treated with low-dose atorvastatin. Moreover, oxLDL could be a measure of the degree of stenosis in such patients.
Kougialis
S
S
2nd Department of Internal Medicine, General Hospital of Nikaia and Piraeus, Pireaus, Greece.
Skopelitis
E
E
Gialernios
T
T
Nikolaou
S
S
Kroustalis
A
A
Katsadorou
E
E
Gialernios
K
K
Zervou
A
A
Gika
E
E
Polydorou
A
A
Polydorou
V
V
Drakoulis
C
C
Iliopoulos
N
N
Dermitzakis
I
I
Mpilinis
H
H
Polydorou
A
A
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D016893:Carotid Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D006115:Greece; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed
D015415:Biomarkers; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D011758:Pyrroles; C099252:oxidized low density lipoprotein; D000069059:Atorvastatin