Effects of short-term reduction in serum cholesterol with simvastatin in patients with stable angina pectoris and mild to moderate hypercholesterolemia.

Abstract

To evaluate the effects of short-term cholesterol-lowering treatment on myocardial effort ischemia, 22 patients with stable effort ischemia and mild to moderate hypercholesterolemia (low density lipoprotein [LDL] cholesterol 160 to 220 mg/dl) were randomly allocated at baseline (TO) in 2 groups. Group A included 12 patients treated with simvastatin 10 mg bid; group B included 10 patients treated with placebo. All patients underwent a treadmill electrocardiography (ECG) test; total cholesterol, HDL and LDL cholesterol, triglycerides, plasma, and blood viscosity were measured. All tests were repeated after 4 and 12 weeks. For 18 of the same patients (11 taking simvastatin, 7 receiving placebo), forearm strain-gouge plethysmography was performed at baseline and after 4 weeks, both at rest and during reactive hyperemia. At 4 and 12 weeks, group A showed a significant reduction in total cholesterol (p <0.05) and LDL (p <0.05), with unchanged HDL, triglycerides, blood, and plasma viscosity. Effort was unmodified, ST-segment depression at peak effort and ischemic threshold were significantly improved after 4 and 12 weeks (all p <0.05) with unchanged heart rate x systolic blood pressure product. A significant increase in the excess flow response to reactive hyperemia was detected in group A (p <0.03); group B showed no changes in hematochemical and ergometric parameters. These data suggest that cholesterol-lowering treatment is associated with an improvement in myocardial effort ischemia; this might be explained by a more pronounced increase of coronary blood flow and capacity of vasodilation in response to effort.

• Authors: M de Divitiis, P Rubba, S Di Somma, V Liguori, M Galderisi, S Montefusco, G Carreras, V Greco, A Carotenuto, G Iannuzzo, O de Divitiis
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 78 Issue 7 Pg. 763-8 (Oct 01 1996) ISSN: 0002-9149 [Print] United States
• PMID: 8857479 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anticholesteremic Agents
• Cholesterol, LDL
• Cholesterol
• Lovastatin
• Simvastatin

Topics

• Analysis of Variance
• Angina Pectoris (complications, physiopathology)
• Anticholesteremic Agents (pharmacology, therapeutic use)
• Cholesterol (blood)
• Cholesterol, LDL (blood)
• Electrocardiography
• Exercise Test
• Forearm (blood supply)
• Humans
• Hypercholesterolemia (blood, complications, drug therapy)
• Lovastatin (analogs & derivatives, pharmacology, therapeutic use)
• Middle Aged
• Regional Blood Flow (drug effects)
• Simvastatin
• Single-Blind Method