The effects of cholesterol lowering therapy with atorvastatin on flow-mediated vasodilation in patients with hypercholesterolemic coronary artery disease
Background. Hypercholesterolemia impairs the endothelial function. Lipid-lowering therapy has been reported to improve endothelial function. Aim. To assess the effects of atorvastatin on endothelial function by the measurement of flow-mediated vasodilatation (FMD) in patients with hypercholesterolemia and coronary artery disease (CAD). Methods. In twenty-six patients (mean age 55±5 years) with angiographically proven CAD a high-resolution vascular ultrasound was used at baseline and after two months of atorvastatin therapy (10 mg/day) in order to measure brachial artery responses to reactive hyperaemia and sublingual nitrate (endothelium-independent mechanism). The baseline FMD values obtained in patients were compared with those measured in healthy controls. Results. The FMD values in the control group were significantly higher than in the CAD group (12.5±6% versus 3.8±3%, p<0.001). The FMD improved significantly in CAD patients after the effective lowering of total cholesterol and LDL-cholesterol by atorvastatin therapy (3.8±3% versus 7.2±3.5%, p<0.001) whereas no significant change in the endothelium-independent vasodilation was noted. Conclusions. Endothelium-dependent vasodilatation of the brachial artery is impaired in CAD patients. Significant lowering of cholesterol levels in CAD patients with atorvastatin markedly improves endothelium-dependent arterial vasodilatation
