Early Intensive Atorvastatin Protects Endothelial Function and Reduces Inflammation

SAN FRANCISCO, CA—At ACC.13, the American College of Cardiology's 62nd Annual Scientific Session, Riccardo Raddino, MD, from the University of Bresci and Civil Hospital, Bresci, Italy, presented data demonstrating that early intensive atorvastatin therapy results in great protection of endothelial function and reduction of vascular inflammation than a moderate dose.

Dr. Raddino and colleagues evaluated the effects of early administration of high-dose atorvastatin (80mg) compared to a moderate dose (20mg) on endothelial function and vascular inflammation in patients with STEMI undergoing a percutaneous coronary intervention (PCI). Twenty-six patients were randomized 1:1 to receive atorvastatin 80mg or 20mg. Endothelial function was assessed by a non-invasive finger plethysmography on day 1 and 30 days after acute coronary syndrome (ACS). Levels of hs-PCR, IL 6, TNF-α, ox-LDL were also measured.

Results demonstrated that atorvastatin 80mg was associated with a greater improvement of endothelial function (expressed as % variation of RH-PAT index). Atorvastatin 80mg increased the RH-PAT index from 1.56 ± 0.30 to 1.96 ± 0.16, P<0.0001 vs. increasing from 1.54 ± 0.33 to 1.72 ± 0.19, P=0.03 in the atorvastatin 20mg group.

At Day 30, patients treated with atorvastatin 80mg compared with the 20mg dose showed a major decrease in hs-PCR (0.04 ± 0.04mg/dL vs. 0.36 ± 0.3mg/dL; P= 0.001) and IL-6 ((1.12 ± 0.93pg /mL vs. 3.13 ± 2.84 pg/mL; P=0.03). For TNF-α and ox-LDL the reduction was significant only for the high-dose group (TNF-α: from 10.9 ± 6.01 to 7.54 ± 3.56pg/mL, P=0.03; ox-LDL: from 87.25 ± 34.44ng/mL to 49.08 ± 14.01ng/mL, P<0.0001). A moderate correlation was observed between levels of oxidized LDL and levels of LDL-C at day 30 (r=0.59, P=0.002).

The investigators concluded that the, “protective effects of atorvastatin therapy following ACS may be dose dependent.”