Abstract
The study was aimed at investigating the effects, after treatment for 1 year, of two different statins on the levels of circulating biochemical markers of endothelial function in patients with established coronary heart disease, with the hypothesis that statins might reduce these levels. Twenty-eight patients were randomized to treatment with atorvastatin and 30 to simvastatin for 1 year. The starting dose in both groups was 20 mg/day. Soluble forms of P-selectin, E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were determined to assess inflammatory activity of the endothelium, and tissue plasminogen activator antigen (tPAag), von Willebrand factor and thrombomodulin for evaluation of the haemostatic function. In the total study population there were significantly reduced levels after 1 year treatment in ICAM-1 (P<0.001), E-selectin (P=0.022) and P-selectin (P<0.001), whereas a significant increase was observed in VCAM-1 (P=0.003). Almost the same pattern was seen within both groups although the increase in VCAM-1 was only seen in the simvastatin group (P=0.017). An overall reduction in tPAag was further observed (P=0.048). The reduction in proinflammatory and to some extent haemostatic markers of endothelial function after 1 year treatment with either simvastatin or atorvastatin may be indicative of a less activated state of the endothelium which possibly may contribute to modulation of the progression of atherosclerosis.
Publication types
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Clinical Trial
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Comparative Study
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Multicenter Study
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Apolipoprotein A-I / blood
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Apolipoprotein A-I / drug effects
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Apolipoproteins B / blood
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Apolipoproteins B / drug effects
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Atorvastatin
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Biomarkers / blood
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Cholesterol, HDL / blood
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Cholesterol, HDL / drug effects
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Cholesterol, LDL / blood
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Cholesterol, LDL / drug effects
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Coronary Disease / blood
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Coronary Disease / drug therapy*
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Double-Blind Method
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Drug Evaluation
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E-Selectin / blood
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E-Selectin / drug effects
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Endothelium, Vascular / cytology*
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Endothelium, Vascular / drug effects*
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Endothelium, Vascular / metabolism
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Female
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Heptanoic Acids / therapeutic use*
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
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Intercellular Adhesion Molecule-1 / blood
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Intercellular Adhesion Molecule-1 / drug effects
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Male
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Norway / epidemiology
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P-Selectin / blood
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P-Selectin / drug effects
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Pyrroles / therapeutic use*
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Simvastatin / therapeutic use*
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Statistics as Topic
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Thrombomodulin / blood
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Thrombomodulin / drug effects
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Tissue Plasminogen Activator / blood
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Tissue Plasminogen Activator / drug effects
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Treatment Outcome
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Triglycerides / blood
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Vascular Cell Adhesion Molecule-1 / blood
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Vascular Cell Adhesion Molecule-1 / drug effects
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von Willebrand Factor / drug effects
Substances
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Apolipoprotein A-I
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Apolipoproteins B
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Biomarkers
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Cholesterol, HDL
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Cholesterol, LDL
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E-Selectin
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Heptanoic Acids
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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P-Selectin
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Pyrroles
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Thrombomodulin
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Triglycerides
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Vascular Cell Adhesion Molecule-1
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von Willebrand Factor
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Intercellular Adhesion Molecule-1
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Atorvastatin
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Simvastatin
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Tissue Plasminogen Activator