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

Abstract

Introduction. Patients with systemic lupus erythematosus (SLE) have recognized reduction in endothelium-dependent vasodilation. Evidence demonstrates that statins are able to improve endothelial function independently on their hypolipemic action. Objectives. To evaluate the efficacy of atorvastatin in improving vasodilation in SLE patients with and without conventional risk factors for coronary heart disease (CHD). Patients and methods. Sixty-four SLE women, mean age 31 AE 8 yrs, received atorvastatin 20 mg/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 AE 7.5 yrs, not receiving atorvastatin were followed during the same time period. Highresolution 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 ¼ 0.514]. FMD increase was observed in patients with conventional risk factors [4.1 (3.1-8.7%) vs 6.5 (4-10%), P ¼ 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 ¼ 0.001]. Resting brachial artery diameter also increased significantly in patients receiving atorvastatin (2.79 AE 0.30 mm vs 2.92 AE 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 (þ0.13 AE 0.1 mm vs -0.02 AE 0.07 mm, P < 0.001) and FMD (þ1.9 AE 3.9% vs -0.3 AE 1.8%, P ¼ 0.009).Conclusion. Our results demonstrate that an 8-week 20 mg/day atorvastatin series improved endothelium-dependent vasodilation in SLE patients independently on the presence of conventional risk factors for atherosclerotic disease.

Accelerated Atherosclerosis in Systemic Lupus Erythematosus: Role of Proinflammatory Cytokines and Therapeutic Approaches

“…Another statin, simvastatin, led to a similar reduction in disease activity in female patients [15]. A 1-year trial with atorvastatin demonstrated a decrease in cholesterol levels, proteinuria, and rate of progression of chronic kidney disease in patients with SLE with LN [16]. TNF-α has been shown to be a potential target in the treatment of SLE, and there is a role for the HMG-CoA reductase inhibitor simvastatin [17].…”

Effect of fluvastatin on cardiac outcomes in kidney transplant patients with systemic lupus erythematosus: A randomized placebo‐controlled study

“…However, the available data from that study are preliminary and have been presented only in abstract form; a full report is awaited. In a short-term study of patients with SLE, atorvastatin improved endothelium-dependent vasodilatation independently of the presence of conventional risk factors (12), indicating that atorvastatin may be useful in preventing atherosclerotic cardiovascular complications in this clinical setting.…”

Era of Vaccination Heralds a Decline in Incidence of Hepatitis A in High-Risk Groups in China

“…Recent studies show that statins can also interfere with Th1/Th2 balance as well as MHC class II expression, which can lead to changes in immune responsiveness (11,(17)(18)(19). In this regard, many studies evaluated the effects of this drug on various immunologic-related conditions such as rheumatologic diseases (20)(21)(22)(23), response to different vaccines (12,14,24), central nervous system autoimmune diseases (25)(26)(27), and chronic obstructive pulmonary disease (28).…”