Abstract 13758: Impact of Chronic Statin Administration on Acetylcholine-Induced Endothelial Dysfunction
Background : Coronary artery spasm (CAS) is caused by endothelial dysfunction and statin improves endothelial function by increasing endothelial nitric oxide (NO) production. Withdrawal of statin therapy could cause a suppression of endothelial NO production and impair vascular function. However, there has been limited data regarding the impact of statin use on Ach induced endothelial dysfunction.
Method : A total 1504 consecutive patients without significant CAD who underwent the Ach provocation test by injecting incremental doses of 20, 50, 100ug into the left coronary artery were enrolled between November 2004 and October 2010. Significant CAS was defined as focal or diffuse severe transient luminal narrowing (>70%) with/without chest pain or ST-T change on ECG. The Ach provocation test results and its associated parameters were compared between the statin group (n=801) and control group (no statin, n=1703).
Results : At baseline characteristics, the stain group had higher incidence of old age and higher BMI than control group. Further, classical coronary risk factors including hypertension, diabetes, dyslipidemia, and current alcoholics were more prevalent in the statin group. During Ach provocation test, the statin group showed higher incidence of severe spasm, multivessel spasm and diffuse long spasm. Multivariate analysis showed that statin use was associated with significant Ach induced CAS (odds ratio : 1.515, confidence interval: 1.229-1.866, p<0.001).
Conclusion : In this study, chronic statin use was significantly associated with Ach induced severe, multivessel and diffuse spasm in all comer Asian population. Chronic statin use may be protective, however, because of the higher prevalence of multiple risk factors in the statin group, more advanced endothelial dysfunction were observed.
- © 2012 by American Heart Association, Inc.