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Atorvastatin treatment improves endothelial function in patients with acute coronary syndrome by reducing inflammatory adhesion molecules and increasing flow-mediated dilatation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2014Open Access

Effect of Statins on Endothelial Function in Patients With Acute Coronary Syndrome: A Prospective Study Using Adhesion Molecules and Flow-Mediated Dilatation

Structured PICO

Does atorvastatin 40 mg/day improve endothelial function in male patients with acute coronary syndrome?

Population

30 male patients presenting with acute coronary syndrome (ACS) and 26 age-matched healthy control subjects aged 40 - 60 years who were not on any medication

Intervention

Atorvastatin 40 mg/day

Comparator

Baseline values (before-after comparison) and healthy control subjects

Outcome

Endothelial function assessed using biochemical markers (endothelin, sICAM, E-selectin) and brachial artery flow-mediated dilatation (FMD)surrogate

Atorvastatin 40 mg/day improves endothelial function and reduces inflammatory adhesion molecules in male patients with acute coronary syndrome.

Abstract

BACKGROUND: Accumulating evidence suggests that inflammatory mechanisms play a central role in the development, progression and outcome of atherosclerosis. Recent evidence suggests that statins improve anti-inflammatory, anti-thrombotic and endothelial functions, along with their lipid-decreasing effects. We examined the effect of statins on endothelial function using biochemical markers of endothelial dysfunction and brachial artery flow-mediated dilatation (FMD). METHODS: Thirty male patients presenting with acute coronary syndrome (ACS) and 26 age-matched healthy control subjects aged 40 - 60 years who were not on any medication were enrolled in the study. The patient group was started on atorvastatin (40 mg/day) without consideration of their low-density lipoprotein (LDL)-cholesterol levels. Endothelin, sICAM and E-selectin from stored serum samples were measured using commercially available enzyme-linked immunosorbant assays (ELISAs). Endothelial function was assessed using brachial artery FMD. RESULTS: Prior to statin treatment, E-selectin, sICAM and endothelin levels, endothelial dysfunction markers, were 99.74 ± 34.67 ng/mL, 568.8 ± 149.0 ng/mL and 0.62 ± 0.33 fmol/mL, respectively in the patient group. E-selectin and sICAM levels were significantly higher in the patients than in the control subjects (P < 0.001); however, endothelin levels were not significantly different between groups. Statin treatment significantly reduced E-selectin and sICAM levels (P < 0.001); however, the decrease in endothelin levels was not statistically significant. %FMD values were significantly increased after statin treatment (P = 0.005), and levels of C-reactive protein (CRP), an inflammation marker, were significantly reduced. CONCLUSION: Our results indicate that statins play an important role in treatment endothelial dysfunction by reducing adhesion of inflammatory cells.

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