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STATINS MIGHT IMPROVE CORONARY BLOOD FLOW AFTER PERCUTANEOUS CORONARY INTERVENTION
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Poster Sessions PO48 Therapeutic interventions – statins risk factors of CAD.Post-PCI CTFC in group 3 was significantly higher than the all group of taking statin (21±9 vs 17±7,p=0.02).Post-PCI CTFC in group 2 was found lower than group 1 (15±4 vs 18±6,p=0.01).Hs-CRP in group 3 was measured higher than group 1 and 2 (6.4±2 mg/L vs 3.2±1.0 mg/L and 1.4±0.7 mg/L,p=0.01).Hs-CRP levels between the group 1 and 2 were significantly different (3.2±1.0 mg/L vs 1.4±0.7 mg/L,p=0.03).There was a positive correlation between the hs-CRP levels and post-PCI CTFC in all groups (R=0.545, p=0.01). Conclusions: Pre-PCI statin use might improve coronary blood flow after intervention in patients with SCAD through its beneficial effects on inflammation. PO48-746
Treatment with high-dose atorvastatin to a mean LDL-C of 77mg/dL considerably attenuated the predictive power associated with 3 major components of MS. PO48-744
EFFECT OF ROSUVASTATIN ON ARTERIAL FUNCTION AND STRUCTURE IN PATIENTS WITH FAMILIAL COMBINED HYPERLIPIDEMIA
C. Masoura, C. Pitsavos, I. Skoumas, K. Aznaouridis, C. Vlachopoulos, L. Papadimitriou, N. Giotsas, C. Stefanadis. 1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece Background and aims: Familial combined hyperlipidemia (FCH) is related to increased cardiovascular risk. Arterial structure and function are predictors of outcomes. We explored the effect of rosuvastatin on arterial function and subclinical atherosclerosis in FCH patients. Methods: We studied 14 never treated, normotensives, non-diabetic FCH subjects (age 45) without cardiovascular disease. Arterial studies were performed before and 6 months after treatment with rosuvastatin 20 mg daily. Endothelium-dependent flow-mediated dilatation (FMD) and endothelium-independent nitrate-mediated dilatation (NMD) of the brachial artery, carotid-femoral pulse wave velocity (PWV, index of aortic stiffness) and aortic augmentation index (AIx, marker of arterial wave reflections), were measured non-invasively. Subclinical carotid atherosclerotic was evaluated by intima-media thickness (IMT) and presence of plaques (IMT>1.5 mm) in 6 carotid territories (right and left common carotid, bulb and internal carotid arteries) by ultrasonography. Results: Rosuvastatin increased FMD (9.1 vs. 3.5%, P<0.001) and FMD/NMD (0.63 vs. 0.30, P<0.001) and decreased PWV (7.9 vs. 8.5 m/sec, P<0.001). We observed no change in AIx (17.3 vs. 16.9%, P=NS). Furthermore, rosuvastatin caused a significant reduction in the mean number of carotid plaques (1.4 vs. 2.0, P=0.005) and in IMT of common carotid (0.77 vs. 0.86 mm, P=0.044), bulb (1.17 vs. 1.28mm, P=0.005) and internal carotid artery (0.94 vs. 1.07 mm, P=0.003). Multivariable analysis showed that the above arterial changes were not fully accounted for by the decrease in blood lipids. Conclusions: In patients with FCH, rosuvastatin improves endothelial function and aortic stiffness and results in regression of subclinical carotid atherosclerosis, independently of lipid reduction.
S.J. Nicholls 1 , J.S. Raichlen 2 , C.M. Ballantyne 3 , P.J. Barter 4 , M.J. Chapman 5 , R. Erbel 6 , P. Libby 7 , S.E. Nissen 1 . 1 Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, Ohio, USA; 2 AstraZeneca, Wilmington, Delaware, USA; 3 Baylor College of Medicine, Houston, Texas, USA; 4 Heart Research Institute, 145 Missenden Road, Camperdown, Sydney, Australia; 5 Hopital de la Pitie, Paris, France; 6 West German Heart Center, Essen, Germany; 7 Brigham & Women’s Hospital, Boston, Massachusetts, USA Background: Serial determination of coronary atheroma burden by intravascular ultrasound (IVUS) has proven a reliable method for assessing the effects of statin treatment. Maximum dosages of two statins (rosuvastatin and atorvastatin) limit disease progression. Prior studies indicate that statins influence plaque progression by lowering LDL cholesterol and C-reactive protein, and raising HDL cholesterol. However, it remains to be determined how these factors influence the ability of individual high-efficacy statins to slow disease progression in patients with coronary artery disease (CAD). Methods: SATURN (Study of Coronary Atheroma by InTravascular Ultrasound: Effect of Rosuvastatin versus AtorvastatiN) is a phase IV, multicentre, double-blind, parallel-group study in men and women (18–75 years) with angiographic CAD. A total 1300 patients with LDL cholesterol levels >100 mg/dL for statin-naive patients and >80 mg/dL for patients on statins will be randomised at 170 centres worldwide. Patients will be treated with rosuvastatin 40 mg or atorvastatin 80 mg daily for 104 weeks. Atherosclerosis progression will be assessed in a matched segment of a single coronary artery by IVUS at baseline and the end of treatment. The primary objective is to compare the effects of rosuvastatin 40 mg versus atorvastatin 80 mg on progression of coronary atherosclerosis. Additionally, the impact of these therapies on lipoprotein levels, inflammatory markers and safety will be assessed throughout the study. Conclusions: The findings of SATURN will provide important insights into understanding how statin therapy can have the greatest impact on the progression of atherosclerosis in CAD patients. PO48-747
PO48-745
STATINS MIGHT IMPROVE CORONARY BLOOD FLOW AFTER PERCUTANEOUS CORONARY INTERVENTION
H. Duygu, U. Turk, S. Saygi, B. Kirilmaz, E. Aliyev, C. Turkoglu. Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey Background and aims: Statins have favourable effects on the vascular system.The aim of this study was to determine the relationship between the post-intervention corrected TIMI frame count (CTFC) and pre-PCI statin use in patients with stable coronary artery disease (SCAD). Methods: A total of 87 patients (mean age:56±8 years, 53 men) with SCAD who underwent PCI were included in the study.The study population was divided into three groups. Group 1 consisted of 29 patients taking 10 mg/day atorvastatin for at least 6 months, group 2 consisted of 31 patients taking 40 mg/day atorvastatin for at least 6 months, and group 3 consisted of 27 patients taking no statin. PCI was applied on de novo type A lesions. High-sensitive C-reactive protein (hs-CRP) levels were measured before the PCI.CTFC was calculated for each coronary artery after the PCI. Results: The study population had similar characteristics in terms of preprocedural medications, lesion properties, pre-procedural CTFC, and
INTRAVASCULAR ULTRASOUND EVALUATION OF THE EFFECT OF ROSUVASTATIN VERSUS ATORVASTATIN ON PROGRESSION OF CORONARY ATHEROSCLEROSIS: DESIGN OF THE SATURN STUDY
COMPARATIVE EFFECTIVENESS OF ATORVASTATIN, SIMVASTATIN, LOVASTATIN AND FLUVASTATIN ON PULSE WAVE VELOCITY AT PATIENTS WITH DISLIPIDEMIA AND HIGH CARDIOVASCULAR RISK
V. Tsoma, U. Brel, T. Chalabi, G. Mazina, S. Nedogoda. Medical University, Volgograd, Russia Background/Aim: Effectiveness of Atorvastatin, Simvastatin, Lovastatin and Fluvastatin on PWV, lipid metabolism in patients with dislipidemia IIa/IIb type and cardiovascular risk factors, was assessed. Design and methods: 120 subjects were included (37 males, 83 females, aged 56,8±8,6 years). PWV on carotid-femoral and carotid-radial segments, Endothelialindependent vasodilatation (EIV) were assessed according to standard protocol before and after 12 weeks of treatment in 4 groups of patients, who were randomly assigned to Atorvastatin 10 mg, Simvastatin 20 mg, Lovastatin 20 mg or Fluvastatin 80 mg od monotherapy groups. All patients underwent: 1) Total Cholesterol, HDL Cholesterol, LDL Cholesterol, Tryglicerids 2) Clinical blood pressure measurement; 3) Body mass index (BMI).
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO48 Therapeutic interventions – statins risk factors of CAD.Post-PCI CTFC in group 3 was significantly higher than the all group of taking statin (21±9 vs 17±7,p=0.02).Post-PCI CTFC in group 2 was found lower than group 1 (15±4 vs 18±6,p=0.01).Hs-CRP in group 3 was measured higher than group 1 and 2 (6.4±2 mg/L vs 3.2±1.0 mg/L and 1.4±0.7 mg/L,p=0.01).Hs-CRP levels between the group 1 and 2 were significantly different (3.2±1.0 mg/L vs 1.4±0.7 mg/L,p=0.03).There was a positive correlation between the hs-CRP levels and post-PCI CTFC in all groups (R=0.545, p=0.01). Conclusions: Pre-PCI statin use might improve coronary blood flow after intervention in patients with SCAD through its beneficial effects on inflammation. PO48-746
Treatment with high-dose atorvastatin to a mean LDL-C of 77mg/dL considerably attenuated the predictive power associated with 3 major components of MS. PO48-744
EFFECT OF ROSUVASTATIN ON ARTERIAL FUNCTION AND STRUCTURE IN PATIENTS WITH FAMILIAL COMBINED HYPERLIPIDEMIA
C. Masoura, C. Pitsavos, I. Skoumas, K. Aznaouridis, C. Vlachopoulos, L. Papadimitriou, N. Giotsas, C. Stefanadis. 1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece Background and aims: Familial combined hyperlipidemia (FCH) is related to increased cardiovascular risk. Arterial structure and function are predictors of outcomes. We explored the effect of rosuvastatin on arterial function and subclinical atherosclerosis in FCH patients. Methods: We studied 14 never treated, normotensives, non-diabetic FCH subjects (age 45) without cardiovascular disease. Arterial studies were performed before and 6 months after treatment with rosuvastatin 20 mg daily. Endothelium-dependent flow-mediated dilatation (FMD) and endothelium-independent nitrate-mediated dilatation (NMD) of the brachial artery, carotid-femoral pulse wave velocity (PWV, index of aortic stiffness) and aortic augmentation index (AIx, marker of arterial wave reflections), were measured non-invasively. Subclinical carotid atherosclerotic was evaluated by intima-media thickness (IMT) and presence of plaques (IMT>1.5 mm) in 6 carotid territories (right and left common carotid, bulb and internal carotid arteries) by ultrasonography. Results: Rosuvastatin increased FMD (9.1 vs. 3.5%, P<0.001) and FMD/NMD (0.63 vs. 0.30, P<0.001) and decreased PWV (7.9 vs. 8.5 m/sec, P<0.001). We observed no change in AIx (17.3 vs. 16.9%, P=NS). Furthermore, rosuvastatin caused a significant reduction in the mean number of carotid plaques (1.4 vs. 2.0, P=0.005) and in IMT of common carotid (0.77 vs. 0.86 mm, P=0.044), bulb (1.17 vs. 1.28mm, P=0.005) and internal carotid artery (0.94 vs. 1.07 mm, P=0.003). Multivariable analysis showed that the above arterial changes were not fully accounted for by the decrease in blood lipids. Conclusions: In patients with FCH, rosuvastatin improves endothelial function and aortic stiffness and results in regression of subclinical carotid atherosclerosis, independently of lipid reduction.
S.J. Nicholls 1 , J.S. Raichlen 2 , C.M. Ballantyne 3 , P.J. Barter 4 , M.J. Chapman 5 , R. Erbel 6 , P. Libby 7 , S.E. Nissen 1 . 1 Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, Ohio, USA; 2 AstraZeneca, Wilmington, Delaware, USA; 3 Baylor College of Medicine, Houston, Texas, USA; 4 Heart Research Institute, 145 Missenden Road, Camperdown, Sydney, Australia; 5 Hopital de la Pitie, Paris, France; 6 West German Heart Center, Essen, Germany; 7 Brigham & Women’s Hospital, Boston, Massachusetts, USA Background: Serial determination of coronary atheroma burden by intravascular ultrasound (IVUS) has proven a reliable method for assessing the effects of statin treatment. Maximum dosages of two statins (rosuvastatin and atorvastatin) limit disease progression. Prior studies indicate that statins influence plaque progression by lowering LDL cholesterol and C-reactive protein, and raising HDL cholesterol. However, it remains to be determined how these factors influence the ability of individual high-efficacy statins to slow disease progression in patients with coronary artery disease (CAD). Methods: SATURN (Study of Coronary Atheroma by InTravascular Ultrasound: Effect of Rosuvastatin versus AtorvastatiN) is a phase IV, multicentre, double-blind, parallel-group study in men and women (18–75 years) with angiographic CAD. A total 1300 patients with LDL cholesterol levels >100 mg/dL for statin-naive patients and >80 mg/dL for patients on statins will be randomised at 170 centres worldwide. Patients will be treated with rosuvastatin 40 mg or atorvastatin 80 mg daily for 104 weeks. Atherosclerosis progression will be assessed in a matched segment of a single coronary artery by IVUS at baseline and the end of treatment. The primary objective is to compare the effects of rosuvastatin 40 mg versus atorvastatin 80 mg on progression of coronary atherosclerosis. Additionally, the impact of these therapies on lipoprotein levels, inflammatory markers and safety will be assessed throughout the study. Conclusions: The findings of SATURN will provide important insights into understanding how statin therapy can have the greatest impact on the progression of atherosclerosis in CAD patients. PO48-747
PO48-745
STATINS MIGHT IMPROVE CORONARY BLOOD FLOW AFTER PERCUTANEOUS CORONARY INTERVENTION
H. Duygu, U. Turk, S. Saygi, B. Kirilmaz, E. Aliyev, C. Turkoglu. Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey Background and aims: Statins have favourable effects on the vascular system.The aim of this study was to determine the relationship between the post-intervention corrected TIMI frame count (CTFC) and pre-PCI statin use in patients with stable coronary artery disease (SCAD). Methods: A total of 87 patients (mean age:56±8 years, 53 men) with SCAD who underwent PCI were included in the study.The study population was divided into three groups. Group 1 consisted of 29 patients taking 10 mg/day atorvastatin for at least 6 months, group 2 consisted of 31 patients taking 40 mg/day atorvastatin for at least 6 months, and group 3 consisted of 27 patients taking no statin. PCI was applied on de novo type A lesions. High-sensitive C-reactive protein (hs-CRP) levels were measured before the PCI.CTFC was calculated for each coronary artery after the PCI. Results: The study population had similar characteristics in terms of preprocedural medications, lesion properties, pre-procedural CTFC, and
INTRAVASCULAR ULTRASOUND EVALUATION OF THE EFFECT OF ROSUVASTATIN VERSUS ATORVASTATIN ON PROGRESSION OF CORONARY ATHEROSCLEROSIS: DESIGN OF THE SATURN STUDY
COMPARATIVE EFFECTIVENESS OF ATORVASTATIN, SIMVASTATIN, LOVASTATIN AND FLUVASTATIN ON PULSE WAVE VELOCITY AT PATIENTS WITH DISLIPIDEMIA AND HIGH CARDIOVASCULAR RISK
V. Tsoma, U. Brel, T. Chalabi, G. Mazina, S. Nedogoda. Medical University, Volgograd, Russia Background/Aim: Effectiveness of Atorvastatin, Simvastatin, Lovastatin and Fluvastatin on PWV, lipid metabolism in patients with dislipidemia IIa/IIb type and cardiovascular risk factors, was assessed. Design and methods: 120 subjects were included (37 males, 83 females, aged 56,8±8,6 years). PWV on carotid-femoral and carotid-radial segments, Endothelialindependent vasodilatation (EIV) were assessed according to standard protocol before and after 12 weeks of treatment in 4 groups of patients, who were randomly assigned to Atorvastatin 10 mg, Simvastatin 20 mg, Lovastatin 20 mg or Fluvastatin 80 mg od monotherapy groups. All patients underwent: 1) Total Cholesterol, HDL Cholesterol, LDL Cholesterol, Tryglicerids 2) Clinical blood pressure measurement; 3) Body mass index (BMI).
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey