Atorvastatin therapy improves endothelial-dependent vasodilation in patients with systemic lupus erythematosus: an 8 weeks controlled trial

• Autor(a) principal: Ferreira, G. A. [UNIFESP]
• Data de Publicação: 2007
• Outros Autores: Navarro, T. P., Telles, R. W., Andrade, L. E. C. [UNIFESP], Sato, E. I. [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1093/rheumatology/kem186; http://repositorio.unifesp.br/handle/11600/30053
• topic: systemic lupus erythematosus; atorvastatin; endothelial function; vascular ultrasound; atherosclerosis

Introduction. Patients with systemic lupus erythematosus (SLE) have recognized reduction in endothelium-dependent vasoclilation. Evidence demonstrates that statins are able to improve endothelial function independently on their hypolipemic action.Objectives. To evaluate the efficacy of atorvastatin in improving vasoclilation in SLE patients with and without conventional risk factors for coronary heart disease (CHD).Patients and methods. Sixty-four SLE women, mean age 31 +/- 8yrs, received atorvastatin 20mg/day during 8 weeks. Thirty-one patients in this intervention group did not have conventional risk factors for CHD, while 33 others had hypertension, dyslipidaemia and/or obesity. Twenty-four SLE control patients, mean age 34 +/- 7.5yrs, not receiving atorvastatin were followed during the same time period. High-resolution ultrasound was used to measure brachial artery diameter in resting conditions, during reactive hyperaemia and after sub-lingual glyceryl trinitrate (GTN). Measurements were performed at baseline and at the end of the study (8 weeks).Results. Atorvastatin was associated with a significant increase in flow-mediated dilation (FMD) [3.8 (2.8-7.9%) vs 6.9 (4.2-10.7%), P < 0.001] while GTN-mediated dilation (GTND) was unaffected [20.9 (16.6-26.1 %) vs 20.1(16.6-25.4%), P = 0.514]. FMD increase was observed in patients with conventional risk factors [4.1 (3.1-8.7%) vs 6.5 (4-10%), P= 0.046] and also for those without conventional risk factors for CHD [3.6 (2.6-7.3%) vs 7.1 (4.5-10.9%), P=0.001]. Resting brachial artery diameter also increased significantly in patients receiving atorvastatin (2.79 +/- 0.30 mm vs 2.92 +/- 0.40 mm, P < 0.001). No significant difference in artery diameter and FMD was seen in control patients at the end of the study. When compared to the control patients, atorvastatin treatment was associated with significant increase in resting diameter (+13 +/- .1 mm vs-0.02 +/- 0.07mm, P<0.001) and FMD (+1.9 +/- 3.9% vs-0.3 +/- 1.8%, P=0.009).Conclusion. Our results demonstrate that an 8-week 20 mg/day atorvastatin series improved endothelium-dependent vasoclilation in SLE patients independently on the presence of conventional risk factors for atherosclerotic disease.