Abstract 847: Effect of Statins on Arterial Characteristics in Familial Hypercholesterolemia: A Meta-Analysis of Longitudinal Studies
Objectives: We conducted this research to calculate quantitative estimates for the effect of statins on arterial structural and functional characteristics in patients with familial hypercholesterolemia (FH).
Methods: We identified 6 longitudinal studies (8 cohorts) reporting data on the effect of statins on flow-mediated dilation of the brachial artery (FMD, a measure of endothelial function). We also identified studies reporting data on statins and carotid and femoral intima-media thickness [cIMT and fIMT, measures of subclinical atherosclerosis; 7 studies (8 cohorts) and 4 studies (5 cohorts) respectively]. The intensity of treatment was defined according to data on statins equivalency (rosuvastatin 10 mg = atorvastatin 20 mg = simvastatin 40 mg = 1 arbitrary unit of intensity).
Results: Statins improved FMD [absolute pooled weighted mean difference (WMD): 0.99%, 95% CI 0.68 to 1.30%, P<0.001, Fig. A⇓], but not endothelium-independent nitrate-mediated dilation [WMD from 3 cohorts: 0.09%, 95% CI −0.36 to 0.53%, P=NS]. Statins decreased cIMT (WMD: −0.17 mm, 95% CI −0.27 to −0.06 mm, P<0.01, Fig. B⇓) but did not affect fIMT (WMD: −0.02 mm, 95% CI −0.28 to 0.25 mm, P=NS). Meta-regression analysis showed that the extent of FMD improvement was associated with the duration × treatment intensity product (P=0.05). We also found a significant relationship between the decrease of IMT of the common carotid artery and the decrease of LDL-cholesterol with statins. (P<0.05).
Conclusions: Treatment with statins improves arterial function and structure in FH patients. It seems that the intensity of the therapy and the reduction of lipid level determine these favorable effects of statins.