title: The Carotid intima-media thickness modification following atorvastatin is bound to the modification of the oxidative balance.
abstract: BACKGROUND
  Despite the reduction in cholesterol (CH) levels, the modification of carotid intima-media thickness (CIMT) is not evident in all the patients treated with statins. Activities other than CH reduction may determine the improvement in CIMT.
  
  
  METHODS
  Twenty-two patients with hypercholesterolemia (aged 45-60; males) with CIMT increase started the treatment with atorvastatin. The CIMT (via echography), CH level, and the oxidative balance (OB) were measured at baseline and after 4 weeks. The OB consisted of the determination of the plasmatic hydroperoxides (reactive oxygen metabolites [d-ROMs] test) and the antioxidant reserve (plasma antioxidants test [PAT]). The d-ROMs/CH and PAT/CH ratios allowed to measure, respectively, the oxidative index (OI) and the protective index (PI). The OI/PI ratio represented the OB Risk Index (OBRI) to be compared with the CIMT modifications.
  
  
  RESULTS
  An average reduction of 22% in CH was achieved in the group of patients together with an increase in both OI and PI (16% and 39% respectively) with a significant improvement in OBRI from 2.6 to 1.7 (analysis of variance P < .01). A reduction of >20% in CIMT was obtained in 10 patients whereas in the 12 patients no modification of CIMT was detected, despite the same CH reduction (-55 ± 24.8 and -66 ± 27.1 mg/dL respectively; P > .05). Only those patients with a decrease in OBRI ≥0.8 showed a reduction in CIMT >20%.
  
  
  CONCLUSIONS
  In this preliminary study, a significant modification in CIMT was obtained with atorvastatin treatment only in those patients showing an improvement in the OB (OBRI > 0.8).
authors.affiliation: Cardiovascular Research- Arca delle Professioni, University of Chieti-Chieti-Italy, Chieti, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Belcaro
authors.affiliation: Pharmacology & Experimental Therapeutics Department, Loyola University School of Medicine, Chicago, IL, USA.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cornelli
authors.affiliation: Oxidation Research Department, Cor Con International Srl, Parma, Italy finco.annarosa@libero.it.
authors.forename: Annarosa
authors.initials: A
authors.lastname: Finco
mesh_terms: D000704:Analysis of Variance; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D000069059:Atorvastatin; D002339:Carotid Arteries / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D007558:Italy; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D011758:Pyrroles / Q000494:pharmacology*; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D002784:Cholesterol; D000069059:Atorvastatin
keywords: OBRI; atorvastatin; carotid media–intima thickness; oxidative balance