title: Effects of combination of statin and calcium channel blocker in patients with cardiac syndrome X.
abstract: OBJECTIVE
  Statins and calcium channel blockers have been proven beneficial toward improvement of endothelial function. The aim of this study was to compare the effect of combination therapy of statin and calcium channel blocker with solo treatment in patients with cardiac syndrome X.
  
  
  RESULTS
  Sixty-eight patients with cardiac syndrome X were divided randomly into three groups: fluvastatin (40 mg/day, n=23), diltiazem (90 mg/day, n=22), and combination of fluvastatin (40 mg/day) and diltiazem (90 mg/day, n=23). At the end of 90 days, the coronary flow reserve was improved in the three groups (fluvastatin-treated group: 23.2%; diltiazem-treated group: 12.4%; fluvastatin+diltiazem-treated group: 29.1%, all P<0.05). The time to 1 mm ST segment depression increased significantly in the fluvastatin-treated group (from 241±97 to 410±140 s, P<0.05), the diltiazem-treated group (from 258±91 to 392±124 s, P<0.05), and the fluvastatin+diltiazem-treated group (from 250±104 to 446±164 s, P<0.05). The improvement in coronary flow reserve and prolonged time to 1 mm ST segment depression in the combination treatment group were more remarkable than in those who received monotherapy. Combination therapy also induced a significant increase (35.6%, P<0.05) in nitric oxide and an apparent reduction (48.7%, P<0.05) in endothelin-1.
  
  
  CONCLUSIONS
  Combination treatment with fluvastatin and diltiazem is more effective on endothelial function and exercise tolerance than solo treatment in patients with cardiac syndrome X. The benefits of these drugs may be related to the elevation of nitric oxide and reduction of endothelin-1.
authors.affiliation: aThe Heart Center, Jining First People's Hospital, Jining Departments of bNeurology cOncology, Jinan Central Hospital affiliated to Shandong University dThe Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, People's Republic of China.
authors.forename: Xinling
authors.initials: X
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.forename: Xiangting
authors.initials: X
authors.lastname: Li
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Sun
authors.forename: Hongyan
authors.initials: H
authors.lastname: Yang
authors.forename: Zongyin
authors.initials: Z
authors.lastname: Wu
authors.forename: Jianmin
authors.initials: J
authors.lastname: Yang
mesh_terms: D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002681:China; D003326:Coronary Circulation / Q000187:drug effects; D003331:Coronary Vessels / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D004110:Diltiazem; D004359:Drug Therapy, Combination; D019332:Endothelin-1 / Q000097:blood; D017079:Exercise Tolerance / Q000187:drug effects; D005229:Fatty Acids, Monounsaturated / Q000627:therapeutic use*; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D017566:Microvascular Angina / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D019332:Endothelin-1; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D009569:Nitric Oxide; D000077340:Fluvastatin; D004110:Diltiazem