Effects of Low Dose Versus High Dose Statin Therapy on the Changes of Endothelial Function and Carotid Intima-media Thickness in Patients with Varivnt Angina
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: To compare the effects of low dose and high dose of statin treatment on endothelial function and carotid intimamedia thickness (IMT) in patients with variant angina (VAP). Methods: A total of 70 patients with VAP were divided into two groups; atorvastatin 10 mg treatment group (group I: n = 35,54.2 ± 12.5 years) versus atorvastatin 40 mg treatment group (group II: n = 35, 52.6 ± 9.8 years). Flow mediated vasodilation (FMD) of the brachial artery and IMT of the carotid artery were compared between the groups after 6 months of statin treatment. Results: The baseline FMD and carotid IMT were not different between the groups. After 6 months of statin therapy, FMD was significantly improved in both groups (7.7 ± 2.5% to 8.9 ± 2.2% in group I, p = 0.001, 7.9 ± 2.7% to 9.5 ± 2.8% in group II, p < 0.001), but the degree of FMD change and FMD at 6 month were not different between the groups. Carotid IMT were not changed in both groups after 6 months of statin therapy. Conclusion: The use of statin for 6 months significantly improved endothelial function in patients with VAP, but carotid IMT was not changed. The use of high dose statin did not show significant additional benefit as compared with the use of low dose statin. The present study suggested that statin therapy would be beneficial in the treatment of VAP.
Abstract
Background: To compare the effects of low dose and high dose of statin treatment on endothelial function and carotid intimamedia thickness (IMT) in patients with variant angina (VAP). Methods: A total of 70 patients with VAP were divided into two groups; atorvastatin 10 mg treatment group (group I: n = 35,54.2 ± 12.5 years) versus atorvastatin 40 mg treatment group (group II: n = 35, 52.6 ± 9.8 years). Flow mediated vasodilation (FMD) of the brachial artery and IMT of the carotid artery were compared between the groups after 6 months of statin treatment. Results: The baseline FMD and carotid IMT were not different between the groups. After 6 months of statin therapy, FMD was significantly improved in both groups (7.7 ± 2.5% to 8.9 ± 2.2% in group I, p = 0.001, 7.9 ± 2.7% to 9.5 ± 2.8% in group II, p < 0.001), but the degree of FMD change and FMD at 6 month were not different between the groups. Carotid IMT were not changed in both groups after 6 months of statin therapy. Conclusion: The use of statin for 6 months significantly improved endothelial function in patients with VAP, but carotid IMT was not changed. The use of high dose statin did not show significant additional benefit as compared with the use of low dose statin. The present study suggested that statin therapy would be beneficial in the treatment of VAP.
참고문헌 (30)
- Yasue H, "Coronary artery spasm--clinical features, diagnosis, pathogenesis, and treatment", J Cardiol, 51, pp.2~17 (2008)
- Teragawa H, "Endothelial dysfunction is an independent factor responsible for vasospastic angina", Clin Sci (Lond), 101, pp.707~713 (2001)
- Cho SH, "Endothelial dysfunction, increased carotid artery intima-media thickness and pulse wave velocity, and increased level of inflammatory markers are associated with variant angina", J Cardiol, 54, pp.183~191 (2009)
- Corretti MC, "International Brachial Artery Reactivity Task Force. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force", J Am Coll Cardiol, 39, pp.257~265 (2002)
- 남창욱, "정상 성인에서 고주파 초음파도를 이용한 혈관 내피세포의 기능평가: 가령에 따른 기능평가", Journal of Cardiovascular Ultrasound, 8(1), pp.71~77 (2000), 한국심초음파학회
- Yamagishi M, "Intravascular ultrasound detection of atherosclerosis at the site of focal vasospasm in angiographically normal or minimally narrowed coronary segments", J Am Coll Cardiol, 23, pp.352~357 (1994)
- "Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)", Lancet, 344, pp.1383~1389 (1994)
- Downs JR, "Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS", TexCAPS. Air Force, JAMA, pp.1998, 279[DOI]
- "Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIP ID) Study Group", N Engl J Med, 339, pp.1349~1357 (1998)
- Heart Protection Study Collaborative Group, "MRC", BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial, 2002, pp.360, 7~22
- Merten M, "Cholesterol sulfate: a new adhesive molecule for platelets", Circulation, 103, pp.2032~2034 (2001)
- Lacoste L, "Hyperlipidemia and coronary disease. Correction of the increased thrombogenic potential with cholesterol reduction", Circulation, 92, pp.3172~3177 (1995)
- Ridker PM, "Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events (CARE) Investigators", Circulation, 98, pp.839~844 (1998)
- Dupuis J, "Cholesterol reduction rapidly improves endothelial function after acute coronary syndromes. The RECIFE (reduction of cholesterol in ischemia and function of the endothelium) trial", Circulation, 99, pp.3227~3233 (1999)
- Strandberg TE, "Effect of statins on C-reactive protein in patients with coronary artery disease", Lancet, 353, pp.118~119 (1999)
- 윤경호, "Effect of Additional Statin Therapy on Endothelial Function and Prognosis in Patients With Vasospastic Angina", Korean Circulation Journal, 38(12), pp.638~643 (2008), 대한심장학회
- Walling A, "Long-term prognosis of patients with variant angina", Circulation, 76, pp.990~997 (1987)
- Mancini GB, "Angiotensin-converting enzyme inhibition with quinapril improves endothelial vasomotor dysfunction in patients with coronary artery disease. The TREND (Trial on Reversing ENdothelial Dysfunction) Study", Circulation, 94, pp.258~265 (1996)
- Anderson TJ, "Comparative study of ACE-inhibition, angiotensin II antagonism, and calcium channel blockade on flow-mediated vasodilation in patients with coronary disease (BANFF study)", J Am Coll Cardiol, 35, pp.60~66 (2000)
- 김계훈, "Clinical Effects of Calcium Channel Blocker and Angiotensin Converting Enzyme Inhibitor on Endothelial Function and Arterial Stiffness in Patients with Angina Pectoris", Journal of Korean Medical Science, 24(2), pp.223~231 (2009), 대한의학회
- 이영수, "The Short-term Effect of Atorvastatin on Flow-Mediated Vasodilation, Pulse Wave Velocity and Carotid Intima-Media Thickness in Patients With Moderate Cholesterolemia", Korean Circulation Journal, 38(3), pp.144~151 (2008), 대한심장학회
- Reriani MK, "Effects of statins on coronary and peripheral endothelial function in humans: a systematic review and meta-analysis of randomized controlled trials", Eur J Cardiovasc Prev Rehabil, 18, pp.704~716 (2011)
- Liu B, "Effect of rosuvastatin on ROCK activity, endothelial function, and inflammation in Asian patients with atherosclerosis", Intern Med, 51, pp.1177~1182 (2012)
- Zhang L, "Meta-analysis of the effects of statin therapy on endothelial function in patients with diabetes mellitus", Atherosclerosis, 223, pp.78~85 (2012)
- Ubels FL, "Effects of initial and long-term lipid-lowering therapy on vascular wall characteristics", Atherosclerosis, 154, pp.155~161 (2001)
- Kastelein JJ, "Surrogate markers of atherosclerosis: impact of statins", Atheroscler Suppl, 4, pp.31~36 (2003)
- Kang S, "Effects of statin therapy on the progression of carotid atherosclerosis: a systematic review and meta-analysis", Atherosclerosis, 177, pp.433~442 (2004)
- Kastelein JJ, "Atherosclerosis measured by Bmode ultrasonography: effect of statin therapy on disease progression", Am J Med, 116(Suppl 6A), pp.31S~36S (2004)
- Gibbons GH, "Endothelial function as a determinant of vascular function and structure: a new therapeutic target", Am J Cardiol, 79, pp.3~8 (1997)
- Selwyn AP, "Cell dysfunction in atherosclerosis and the ischemic manifestations of coronary artery disease", Am J Cardiol, 79, pp.17~23 (1997)
