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Randomized Controlled Trial
. 2019 Nov 1;94(5):660-668.
doi: 10.1002/ccd.28157. Epub 2019 Feb 21.

Index of microvascular resistance to assess the effect of rosuvastatin on microvascular function in women with chest pain and no obstructive coronary artery disease: A double-blind randomized study

Ole Geir Solberg  1 , Knut Stavem  2   3   4 , Asgrimur Ragnarsson  5 , Jan-Otto Beitnes  1 , Rita Skårdal  1 , Ingebjørg Seljeflot  2   6 , Thor Ueland  2   7   8 , Pål Aukrust  2   8   9 , Lars Gullestad  1   2   10 , Lars Aaberge  1
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Randomized Controlled Trial

Index of microvascular resistance to assess the effect of rosuvastatin on microvascular function in women with chest pain and no obstructive coronary artery disease: A double-blind randomized study

Ole Geir Solberg et al. Catheter Cardiovasc Interv. .

Abstract

Introduction: Many women undergoing coronary angiography for chest pain have no or only minimal coronary artery disease (CAD). However, despite the lack of obstructive CAD, they still have an increased risk of major adverse cardiovascular events. Pleiotropic effects of statins may influence microvascular function, but if statins improve microvascular function in unselected chest pain patients is not well studied. This study assessed microvascular function by using the thermodilution-derived test "the index of microvascular resistance" (IMR) with the aim of determining the (i) IMR level in women with chest pain and non-obstructive CAD and if (ii) IMR is modified by high-dose statin treatment in these patients. Additional objectives were to identify the influence of statins on the health status as assessed with generic health questionnaires and on biomarkers of endothelial activation.

Materials and methods: The study was a randomized, double-blind, single-center trial comparing 6 months of rosuvastatin treatment with placebo. In total, 66 women without obstructive CAD were included. Mean age was 52.7 years and 55.5 years in the placebo and rosuvastatin group, respectively. Microvascular function was assessed using the IMR, health status was assessed using the SF-36 and EQ-5D questionnaires, and biochemical values were assessed at baseline and 6 months later.

Results and conclusions: In the placebo group IMR was 14.6 (SD 5.7) at baseline and 14.4 (SD 6.5) at follow-up. In the rosuvastatin group IMR was 16.5 (SD 7.5) at baseline and 14.2 (SD 5.8) at follow-up. IMR did not differ significantly between the two study groups at follow-up controlled for preintervention values. C-reactive protein (CRP) was comparable between the groups at baseline, while at follow-up CRP was significantly lower in the rosuvastatin group compared to placebo [0.6 (±0.5) mg/L vs. 2.6 (±3.0) mg/L; p = 0.002]. Whereas rosuvastatin treatment for 6 months attenuated CRP levels, it did not improve microvascular function as assessed by IMR (Clinical Trials.gov NCT01582165, EUDRACT 2011-002630-39.3tcAZ).

Keywords: health status; health-related quality of life; index of microvascular resistance; microvascular angina; rosuvastatin; statin.

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REFERENCES

    1. Quyyumi AA. Women and ischemic heart disease: Pathophysiologic implications from the Women's ischemia syndrome evaluation (WISE) study and future research steps. J Am Coll Cardiol. 2006;47:S66-S71.
    1. Jespersen L, Hvelplund A, Abildstrom SZ, et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33:734-744.
    1. Johnson BD, Shaw LJ, Pepine CJ, et al. Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: Results from the NIH-NHLBI-sponsored Women's Ischaemia syndrome evaluation (WISE) study. Eur Heart J. 2006;27:1408-1415.
    1. Atienza F, Velasco JA, Brown S, Ridocci F, Kaski JC. Assessment of quality of life in patients with chest pain and normal coronary arteriogram (syndrome X) using a specific questionnaire. Clin Cardiol. 1999;22:283-290.
    1. Olson MB, Kelsey SF, Matthews K, et al. Symptoms, myocardial ischaemia and quality of life in women: Results from the NHLBI-sponsored WISE study. Eur Heart J. 2003;24:1506-1514.

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