The influence of low-dose atorvastatin on lipid levels and endothelial vascular function in patients with significant coronary artery stenosis

Abstract

Background: Hyperlipidaemia is a well-established risk factor of the progression of coronary artery disease (CAD). Statins such as atorvastatin, as lipid-lowering agents, can not only normalise serum lipid levels, but also may improve endothelial function, reduce vascular inflammation and enhance plaque stability.

Aim: To evaluate the efficacy of a low-dose atorvastatin regimen (10 mg daily) in patients with CAD.

Methods: Seventy-nine patients with stable angina of II or III functional class and angiographically significant stenosis of coronary arteries (>70%) entered a 12-week treatment period with atorvastatin 10 mg/day. Lipid profile, which included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were assessed at baseline and after treatment at week 12. In addition, flow-mediated vasodilatation (FMD) and nitrate-induced dilation (NID) of the brachial artery were measured before and after treatment.

Results: Among 79 patients included in the study, in 54 (68%) the target TC value <5.0 mmol/l, and in 51 (65%) the LDL-C level <3.0 mmol/l were achieved. Atorvastatin decreased TC level by 31% (p<0.01), LDL-C level by 35% (p<0.01), TG level by 23% (p<0.01) and increased HDL-C level by 8% (p<0.01). FMD was increased by 61 % (p<0.01) and normalised in 88% of patients after 3-month therapy of atorvastatin. NID was increased by 16% (p<0.05).

Conclusion: Low-dose treatment with atorvastatin (10 mg daily) is effective in reducing blood lipids and is associated with the improvement of endothelial function in patients with CAD.