Abstract 13392: Atorvastatin Improves Endothelial Function Independently of Metabolic and Inflammatory Status in Patients With a Cerebrovascular Event
Background. Statins are first-line therapy for primary and secondary stroke prevention due to its beneficial effects on cholesterol levels and on vascular inflammation. Both these effects are associated with improvement of endothelial function, which can contribute to the long-term reduction of clinical events by statins. However, the impact of statin treatment on endothelial function in patients with an acute cerebrovascular event (CVE) is poorly known.
Methods. We studied 29 patients (age 67±12, 17 M) admitted to our Stroke Unit with an acute ischemic CVE (transient ischemic attack or minor ischemic stroke). The main clinical and laboratory variables, including lipid profile and C-reactive protein (CRP) serum levels, were collected in all patients. Endothelial function was assessed within 24 hour of admission by measuring brachial artery dilation in response to post-ischemic forearm hyperemia (flow mediated dilation, FMD). Within 48 hours from admission patients were randomized to receive atorvastatin 40 mg or atorvastatin 20 mg daily. FMD was re-assessed at 3-month follow-up.
Results. FMD improved significantly at follow-up both in patients treated with atorvastatin 40 mg (5.24%±2.4% vs. 7.21%±3.8%) and in those treated with atorvastatin 20 mg (3.79%±1.1% to 5.96%±2.8%; p=0.86 for changes). FMD on admission was lower in patients with CRP levels ≥3 mg/dL than in those with CRP values <3 mg/dL (3.84%±0.9% vs. 5.71%±2.7%; p=0.01), whereas it was similar in patients with cholesterol levels ≥200 mg/dL and in those with cholesterol levels <200 mg/dL (4.67%±2.3% vs. 4.19%±1.2% ). A comparable increase in FMD was observed at 3-month follow-up both in patients with CRP serum levels <3 mg/dL (to 7.87%±4.4%) vs. those with CRP levels ≥3 mg/dL (to 5.88%±2.5%; p=0.91 for changes), as well as in hypercholesterolemic (to 6.51%±3.2%) vs. normocholesterolemic (to 6.65%±3.8%) patients (p=0.56 for changes).
Conclusions. Our data show that early statin administration after a CVE results in a significant improvement of endothelial function at short-term follow-up. This effect was independent of cholesterol serum levels and inflammatory status, thus suggesting that other factors contribute to their pharmacological effect.
- © 2011 by American Heart Association, Inc.