Effects of statins on coronary and peripheral endothelial function in humans: a systematic review and meta-analysis of randomized controlled trials

Reriani, Martin; Dunlay, Shannon M.; Gupta, Bhanu; West, Colin P.; Rihal, Charanjit S.; Lerman, Lilach O.; Lerman, Amir

doi:10.1177/1741826711398430

Cited by 121 publications

(81 citation statements)

References 39 publications

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“…The potential positive health outcomes of this approach is highlighted by the combination therapy of calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors employed to normalise systolic blood pressure where the demonstrated effect of restoring endothelial function 23 significantly improved prognosis independent of the effect on blood pressure reduction. 24 Most of the major classes of CV therapies, including aspirin, statins, ACE inhibitors and some of the new-generation β blockers, have now been shown to improve endothelial function 9,25 albeit recent evidence suggesting that statins can worsen endothelial dysfunction has also been reported. 26 The latter highlights the need for further study into this additional, potentially therapeutic effect and its contribution towards improved clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction in patients with type 2 diabetes post acute coronary syndrome

Lumsden

Andrews

Bobadilla

et al. 2013

Diabetes and Vascular Disease Research

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This single visit study examined whether endothelial function, in addition to cardiovascular (CV) risk factors and plasma microparticle content, was normalised in 15 patients with type 2 diabetes + acute coronary syndrome (ACS) (6 weeks-6 months post cardiac event) undergoing standard clinical care compared to 16 sex-and age-matched healthy controls. Results: While total and low-density lipoprotein (LDL) cholesterol levels were well controlled in the patients with type 2 diabetes + ACS, residual CV risk profiles such as increased body mass index (BMI), systolic blood pressure, glucose levels and triglycerides and lower high-density lipoprotein (HDL) levels were still apparent. Endothelium-dependent responses to acetylcholine (ACh) were significantly lower in type 2 diabetes + ACS patients compared to controls. Correspondingly, the reactive hyperaemic index (RHI) was lower in the patient cohort. Endothelial microparticle (EMP) levels (CD31 + , CD41 − ) were 40% lower in the patient cohort. Simultaneous analysis of platelet microparticle (PMP) levels (CD41 + ) showed no difference between cohorts. Conclusions: Patients with type 2 diabetes suffering from recent ACS exhibit residual CV risk factors despite being on standard clinical care. In addition, these patients continue to present with endothelial dysfunction despite having lower levels of EMPs.

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Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction in patients with type 2 diabetes post acute coronary syndrome

Lumsden

Andrews

Bobadilla

et al. 2013

Diabetes and Vascular Disease Research

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“…A previous meta-analysis [3] including 2213 from 34 randomized trials (including 17 atorvastatin trials) showed that statin therapy improved endothelial function measured by FMD (SMD for net change in FMD 0.68; 95% CI, 0.46 to 0.90; p b 0.001; mean difference in % change in FMD, 1.45%; 95% CI, 1.06% to 1.83%; p b 0.001). The present meta-analysis is more comprehensive and includes 2534 patients from 38 randomized trials of exclusive atorvastatin therapy.…”

mentioning

confidence: 96%

Low-density lipoprotein-independent improvement of flow-mediated dilatation with atorvastatin: A meta-analysis and meta-regression of randomized controlled trials

Takagi¹,

Yamamoto²,

Iwata³

et al. 2012

International Journal of Cardiology

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“…Degree of endothelium-dependent vasodilatation achieved by simvastatin treatment was indeed shown to vary across levels of ADMA (44), pointing in the direction of a possible interaction between statins and dimethylarginines. Statin treatment might improve endothelial function both in RTR (45) and in the general population (46). Endothelial NO synthase is upregulated by statins (47).…”

Section: Discussionmentioning

confidence: 99%

Symmetric Dimethylarginine as Predictor of Graft Loss and All-Cause Mortality in Renal Transplant Recipients.

et al. 2014

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Background. Elevated symmetric dimethylarginine (SDMA) has been shown to predict cardiovascular events and all cause mortality in diverse populations. The potential role of SDMA as a risk marker in renal transplant recipients (RTR) has not been investigated. Methods. We analyzed SDMA in the placebo arm of the Assessment of Lescol in Renal Transplantation study, a randomized controlled trial of fluvastatin in RTR. Mean follow-up was 5.1 years. Patients were grouped into quartiles based on SDMA levels at study inclusion. Relationships between SDMA and traditional risk factors for graft function and all-cause mortality were analyzed in 925 RTR using univariate and multivariate survival analyses.Results. In univariate analysis, SDMA was significantly associated with renal graft loss, all-cause death, and major cardiovascular events. After adjustment for established risk factors including estimated glomerular filtration rate, an elevated SDMA-level (4th quartile, 91.38 Kmol/L) was associated with renal graft loss; hazard ratio (HR), 5.51; 95% confidence interval (CI), 1.95Y15.57; P=0.001, compared to the 1st quartile. Similarly, SDMA in the 4th quartile was independently associated with all-cause mortality (HR, 4.56; 95% CI, 2.15Y9.71; PG0.001), and there was a strong borderline significant trend for an association with cardiovascular mortality (HR, 2.86; 95% CI, 0.99Y8.21; P=0.051). Conclusion. In stable RTR, an elevated SDMA level is independently associated with increased risk of all-cause mortality and renal graft loss.

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Effects of statins on coronary and peripheral endothelial function in humans: a systematic review and meta-analysis of randomized controlled trials

Abstract: Statin therapy is associated with significant improvement in both peripheral and coronary endothelial function. The current study supports a role for statin therapy in patients with endothelial dysfunction.

Cited by 121 publications

References 39 publications

Endothelial dysfunction in patients with type 2 diabetes post acute coronary syndrome

Endothelial dysfunction in patients with type 2 diabetes post acute coronary syndrome

Low-density lipoprotein-independent improvement of flow-mediated dilatation with atorvastatin: A meta-analysis and meta-regression of randomized controlled trials

Symmetric Dimethylarginine as Predictor of Graft Loss and All-Cause Mortality in Renal Transplant Recipients.

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