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- Title
Investigation of the vascular and pleiotropic effects of atorvastatin and pioglitazone in a population at high cardiovascular risk.
- Authors
Forst, Thomas; Wilhelm, Birgit; Pfützner, Andreas; Fuchs, Winfried; Lehmann, Ute; Schaper, Frank; Weber, Matthias; Müller, Jürgen; Konrad, Thomas; Hanefeld, Markolf
- Abstract
We investigated the effect of atorvastatin monotherapy and combined treatment with atorvastatin and pioglitazone on intima-media thickness, vascular function and the cardiovascular risk profile. In all, 148 patients (76 male, 72 female; aged 61.4±6.5 years; body mass index [BMI] 29.2±4.1 kg/m2; mean±SD) with increased cardiovascular (CV) risk factors were randomised. Intima-media thickness (IMT), the augmentation index (Aix@75), the microvascular response to acetylcholine (LDF), lipid status, and plasma levels of intact proinsulin, adiponectin, interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), sCD40L, P-selectin, tissue plasminogen activator (t-PA) and blood lipids were monitored over six months.Atorvastatin treatment, alone and in combination with pioglitazone, revealed a significant regression in IMT (0.923±0.013 to 0.874±0.012 mm and 0.921±0.015 to 0.882±0.015 mm; mean ± SEM; p<0.05 respectively) and Aix@75 (27.3±1.2 to 25.9±1.4; and 25.6±1.4 to 24.8±1.7%; p<0.05). The endothelial response to acetylcholine as measured by laser Doppler fluximetry (LDF) improved during combined treatment (373±57 to 576±153 AU; p<0.05). Addition of pioglitazone to atorvastatin resulted in significant further effects on high-sensitivity C-reactive protein (hsCRP), t-PA, P-selectin, adiponectin, triglycerides and high-density lipoprotein (HDL) cholesterol (p<0.05 respectively).Atorvastatin significantly improved IMT and vascular elasticity. Co-administration of pioglitazone provided additional effects on endothelial function, lipid profile and laboratory markers of inflammation.
- Publication
Diabetes & Vascular Disease Research, 2008, Vol 5, Issue 4, p298
- ISSN
1479-1641
- Publication type
Article
- DOI
10.3132/dvdr.2008.043