title: Atorvastatin in pulmonary arterial hypertension (APATH) study.
abstract: Statins have been shown to both prevent and attenuate pulmonary hypertension in animal models. This study investigates the potential therapeutic benefits of atorvastatin as an affordable treatment for pulmonary hypertension patients. 220 patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) were randomised, double-blind, to receive atrovastatin 10 mg daily or matching placebo in addition to supportive care. At 6 months, 6-min walk distance decreased by 16.6 m in the atorvastatin group and 14.1 m in the placebo group. The mean placebo-corrected treatment effect was -2.5 m (95% CI: -38-33; p=0.96), based on intention to treat. A small nonsignificant increase in pulmonary vascular resistance and fall in cardiac output was seen in both treatment groups. There was no significant difference in the proportion of patients who improved, remained stable or showed a deterioration in World Health Organization functional class between atorvastatin and placebo treatments. Nine patients died in the atorvastatin group and 11 in the placebo group. Serum cholesterol levels fell significantly on atorvastatin treatment. Discontinuation rates were 23.2% and 26.9% on atorvastatin and placebo, respectively. Atorvastatin 10 mg daily has no beneficial effect on the natural history of PAH or CTEPH over 6 months.
authors.affiliation: Pulmonary Vascular Diseases State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Zeng
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Xiong
authors.forename: Lan
authors.initials: L
authors.lastname: Zhao
authors.forename: Guang-Liang
authors.initials: GL
authors.lastname: Shan
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
authors.forename: Fang
authors.initials: F
authors.lastname: Xue
authors.forename: Qing
authors.initials: Q
authors.lastname: Gu
authors.forename: Xin-Hai
authors.initials: XH
authors.lastname: Ni
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Zhao
authors.forename: Xian-Sheng
authors.initials: XS
authors.lastname: Cheng
authors.forename: Martin R
authors.initials: MR
authors.lastname: Wilkins
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL; D004311:Double-Blind Method; D017079:Exercise Tolerance / Q000187:drug effects; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006439:Hemodynamics; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000401:mortality; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D016896:Treatment Outcome; D016138:Walking; D055815:Young Adult
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin