Effects of atorvastatin on arterial endothelial function in coronary bypass surgery

• DOI: 10.1016/j.ejcts.2005.09.013
• Publication Date: 2005-11-05T13:43:26Z
• Authors: Massimo Chello; Costanza Goffredo; Giuseppe Patti; Dario Candura; Rosetta Melfi; Stefano Mastrobuoni; Germano Di Sciascio; Elvio Covino
• Keywords: Adult; Male; Analysis of Variance; Brachial Artery; Hemodynamics; Hyperemia; Middle Aged; 3. Good health; Nitroglycerin; 03 medical and health sciences; Cholesterol; 0302 clinical medicine; Double-Blind Method; Heptanoic Acids; Atorvastatin; Humans; Female; Pyrroles; Endothelium, Vascular; Postoperative Period; Coronary Artery Bypass; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Aged

Endothelial dysfunction represents a critical early component of organ injury following cardiopulmonary bypass. Recent studies demonstrate that the treatment with atorvastatin is associated with a significant improvement of endothelial function independently of its efficacy on cholesterol levels. Therefore, we investigated the effects of preoperative atorvastatin treatment on endothelium function after coronary surgery.Forty patients undergoing coronary surgery were randomized to treatment with atorvastatin (20 mg/die; N=20) or placebo (N=20) 3 weeks before surgery. Twenty normal patients served as control group. The flow-mediated dilations (FMD) of the brachial artery after both reactive hyperemia (endothelium dependent) and nitroglycerin administration (endothelium independent) were evaluated at baseline, at 48 h, and 5 days postoperatively.At baseline, the endothelium-dependent FMD was significantly attenuated in coronary versus normal patients (normal 10.3+/-1.8% vs coronary 4.1+/-1.6%, p<0.01). At 48 h postoperatively all patients exhibited a reduced FMD compared with baseline values: the endothelium-dependent dilatation showed a drop of 60.1+15% in the patients of the placebo group compared with 45.8+16.6% (p<0.05) those in the atorvastatin group. At the univariate analysis, no significant correlation was found between serum levels of either total cholesterol or HDL cholesterol and FMD. The nitroglycerin-induced dilation was not significantly influenced by extracorporeal circulation as well as by atorvastatin treatment.The endothelial dysfunction following cardiopulmonary bypass is improved by the treatment with atorvastatin, by a mechanism unrelated to the drug efficacy of controlling serum cholesterol levels.