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Randomized Controlled Trial
. 2015 Jan 29:10:211-21.
doi: 10.2147/COPD.S76061. eCollection 2015.

Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial

Michelle E John  1 , John R Cockcroft  2 , Tricia M McKeever  3 , William R Coward  1 , Dennis J Shale  2 , Simon R Johnson  1 , Jim G Thornton  4 , Timothy W Harrison  1 , Alan J Knox  1 , Charlotte E Bolton  1
Affiliations
Randomized Controlled Trial

Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial

Michelle E John et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and have anti-inflammatory properties. A proof-of-principle, double-blind, randomized trial determined if 6 weeks of simvastatin 20 mg once daily reduced aortic stiffness and systemic and airway inflammation in patients with chronic obstructive pulmonary disease.

Methods: Stable patients (n=70) were randomized to simvastatin (active) or placebo. Pre-treatment and post-treatment aortic stiffness, blood pressure, spirometry, and circulating and airway inflammatory mediators and lipids were measured. A predefined subgroup analysis was performed where baseline aortic pulse wave velocity (PWV) was >10 m/sec.

Results: Total cholesterol dropped in the active group. There was no significant change in aortic PWV between the active group and the placebo group (-0.7 m/sec, P=0.24). In those with aortic stiffness >10 m/sec (n=22), aortic PWV improved in the active group compared with the placebo group (-2.8 m/sec, P=0.03). Neither systemic nor airway inflammatory markers changed.

Conclusion: There was a nonsignificant improvement in aortic PWV in those taking simvastatin 20 mg compared with placebo, but in those with higher baseline aortic stiffness (a higher risk group) a significant and clinically relevant reduction in PWV was shown.

Trial registration: ClinicalTrials.gov NCT01151306.

Keywords: arterial stiffness; chronic obstructive pulmonary disease; statins.

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Figures

Figure 1
Figure 1
CONSORT diagram of study recruitment, allocation, drop-out and completion. Notes: *Cardiac history, alcohol excess, maintenance prednisolone/antibiotics, withdrew consent, other respiratory diagnosis, never smoker, outside age range.
Figure 2
Figure 2
Change in aortic PWV for active treatment and placebo groups in (A) the total study group and (B) those with a high baseline aortic PWV. Line represents mean drop from baseline. Dotted line indicates active (simvastatin) arm. Black solid line indicates placebo. Error bars indicate the standard error. Abbreviation: PWV, pulse wave velocity.
See this image and copyright information in PMC

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