Effect of intensive lipid-lowering treatment compared to moderate lipid-lowering treatment with rosuvastatin on endothelial function in high risk patients

Abstract

BackgroundThe healthy endothelium plays a key roll in vascular regulation. This function can be examined non-invasively by use of B-mode ultrasound on the brachial artery. The aim of this study was to measure the effect of low-dose and high-dose lipid-lowering treatment with rosuvastatin on the endothelial function evaluated with endothelium-dependent and endothelium-independent flow-mediated dilatation (FMD). Methods87 Statin-naive patients with ST-segment elevation myocardial infarction (STEMI) were randomized to 5mg or 40mg rosuvastatin. The FMD was assessed at baseline, 6months and after 12months of follow-up by use of B-mode ultrasound of the brachial artery. ResultsBaseline low-density lipoprotein (LDL) cholesterol level was reduced by 31.8% in the low-dose group (from 3.1±0.7mmol/l to 2.0±0.4mmol/l, p<0.001) vs. 49.0% in the high-dose group (from 3.1±1.0mmol/l to 1.6±0.7mmol/l, p<0.001) (between groups p=0.001). Treatment with low-dose rosuvastatin did not change the endothelium-dependent FMD (−1.4±8.2%, p=0.32) whereas the endothelium-dependent FMD increased significantly in the high-dose group (3.7±11.0%, p=0.045) (between group p=0.029). No significant changes in endothelium-independent FMD were seen. ConclusionIn the present study treatment of statin-naive STEMI patients with high-dose rosuvastatin for 12months resulted in a significant increase in endothelium-dependent FMD of the brachial artery whereas no significant change was seen in the low-dose rosuvastatin group (Clinicaltrials.gov Identifier: NCT01223625).