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Impact of Atorvastatin Treatment in First-Degree Relatives of Patients With Premature Coronary Artery Disease With Endothelial Dysfunction: A Double-Blind, Randomized, Placebo-Controlled Crossover Trial

 Sung-Jin Hong  ;  Hyuk-Jae Chang  ;  Sungha Park  ;  Dae Ryong Kang  ;  Sanghoon Shin  ;  In-Jeong Cho  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Namsik Chung 
 Clinical Cardiology, Vol.36(8) : 480-485, 2013 
Journal Title
 Clinical Cardiology 
Issue Date
BACKGROUND: A family history of premature coronary artery disease (CAD) is a well-known risk factor for cardiovascular events. HYPOTHESIS: Atorvastatin may improve endothelial dysfunction (ED) in the first-degree relatives (FDRs) of patients with premature CAD with ED. METHODS: Thirty-five FDRs (median age, 52 years [interquartile range (IQR), 46-57 years], 21 male) of patients with premature CAD with ED were recruited in a prospective trial with a crossover double-blind design: 6 weeks of treatment with atorvastatin 40 mg/day followed by placebo, or vice versa. After each treatment, the digital pulse wave amplitude was determined by EndoPAT to obtain the reactive hyperemia index (RHI), a measure for endothelial function. The primary outcome was the difference of RHI between atorvastatin and placebo treatment. RESULTS: Low-density lipoprotein cholesterol was lower after atorvastatin compared with placebo treatment (124 [102-145] mg/dL vs 67 [50-73] mg/dL, P < 0.001). However, RHI was not different after atorvastatin compared with placebo treatment (1.9 [1.5-2.4] vs 1.9 [1.6-2.2], P = 0.902). Also, the augmentation index was similar after each treatment. These results were observed both in subjects who had indications for statin treatment (31%) and those who did not (69%) according to National Cholesterol Education Program Adult Treatment Panel III guidelines. CONCLUSIONS: Despite improvement in the lipid profile, atorvastatin failed to improve ED in the FDRs of patients with premature CAD with ED. Although we identified those with ED in FDRs of patients with premature CAD as a high-risk group for future cardiovascular events, atorvastatin treatment may not be a beneficial primary prevention strategy for this population.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강대용(Kang, Dae Ryong)
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
신상준(Shin, Sang Joon) ORCID logo https://orcid.org/0000-0001-5350-7241
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
홍성진(Hong, Sung Jin) ORCID logo https://orcid.org/0000-0003-4893-039X
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