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Effect of cholesterol-lowering therapy on coronary endothelial vasomotor function in patients with coronary artery

J A Vita1, A C Yeung, M Winniford

  • 1Boston University School of Medicine, Boston, MA, USA. jvita@bu.edu

Circulation
|August 23, 2000
PubMed

Insights

Six months of simvastatin treatment did not significantly improve coronary endothelial vasomotor function in patients with coronary artery disease and mildly elevated cholesterol. Cholesterol-lowering therapy

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Endothelial dysfunction is implicated in cardiovascular disease.
  • Cholesterol-lowering therapies are known to have cardiovascular benefits.

Purpose of the Study:

  • To investigate the effect of simvastatin on coronary endothelial vasomotor function.
  • To determine if simvastatin improves endothelial function in patients with coronary artery disease.

Main Methods:

  • Randomized, double-blind, placebo-controlled study.
  • 60 patients with coronary artery disease received either simvastatin (40 mg/d) or placebo for 6 months.
  • Coronary endothelial vasomotor function was assessed using intracoronary infusions of acetylcholine and substance P.

Main Results:

  • Simvastatin significantly reduced LDL-cholesterol by 40%.
  • Neither simvastatin nor placebo significantly altered epicardial coronary artery constriction in response to acetylcholine.
  • Endothelium-dependent dilation of coronary microvessels, assessed by substance P infusion, showed no significant difference between groups after treatment.

Conclusions:

  • Six months of simvastatin therapy did not significantly improve coronary endothelial vasomotor function in patients with coronary artery disease and mildly elevated cholesterol.
  • The findings suggest that the impact of cholesterol-lowering on endothelial function is complex and may not be solely mediated by direct vasomotor improvements.
  • Further research is needed to elucidate the mechanisms underlying the cardiovascular benefits of statin therapy.
Abstract

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