Effects of combined administration of low dose atorvastatin and vitamin E on inflammatory markers and endothelial function in patients with heart failure.

Abstract

BACKGROUND:

Heart failure has been associated with impaired endothelial function, increased inflammatory process and elevated oxidative stress status. Both statins and vitamin E separately improve endothelial function in patients with hypercholesterolemia and/or advanced atherosclerosis.

AIM:

To evaluate the effect of atorvastatin alone or in combination with vitamin E on endothelial function and serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and vascular cells adhesion molecule (sVCAM-1) in patients with ischemic heart failure.

METHODS:

Thirty-eight male patients with ischemic cardiomyopathy were randomly divided into three groups and received either atorvastatin 10 mg/day (n = 14), a combination of atorvastatin 10 mg/day plus vitamin E 400 IU/day (n = 12), or no statin or antioxidant treatment (n=12, controls) for 4 weeks. Forearm blood flow (FBF) was measured using venous occlusion strain-gauge plethysmography. Forearm vasodilatory response to reactive hyperemia (RH%) or to nitrate (NTG%) was defined as the percent change of FBF from rest to the maximum flow during reactive hyperemia or after nitrate administration, respectively.

RESULTS:

RH% was significantly improved in both the atorvastatin-treated (p < 0.01) and atorvastatin plus vitamin E groups (p < 0.05), but the increase was significantly higher in the atorvastatin-treated group (p < 0.05). Serum levels of IL-6, TNF-alpha and sVCAM-1 were decreased in the atorvastatin-treated group (p < 0.05 for all), but remained unaffected in the other two groups (p = NS for all).

CONCLUSIONS:

Low dose atorvastatin treatment improves endothelial function and reduces the expression of proinflammatory cytokines and adhesion molecules in patients with ischemic heart failure, an effect partly depressed by vitamin E.

• Authors: Dimitris Tousoulis, Charalambos Antoniades, Carmen Vassiliadou, Marina Toutouza, Christos Pitsavos, Costas Tentolouris, Athanasios Trikas, Christodoulos Stefanadis
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 7 Issue 7 Pg. 1126-32 (Dec 2005) ISSN: 1388-9842 [Print] England
• PMID: 16051518 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Antioxidants
• Biomarkers
• Heptanoic Acids
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Interleukin-6
• Pyrroles
• Tumor Necrosis Factor-alpha
• Vascular Cell Adhesion Molecule-1
• Vitamin E
• Atorvastatin

Topics

• Aged
• Antioxidants (administration & dosage, therapeutic use)
• Atorvastatin
• Biomarkers (blood)
• Chromatography, High Pressure Liquid
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Endothelium, Vascular (drug effects, physiopathology)
• Follow-Up Studies
• Heart Failure (blood, drug therapy)
• Heptanoic Acids (administration & dosage, therapeutic use)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, therapeutic use)
• Interleukin-6 (blood)
• Male
• Pyrroles (administration & dosage, therapeutic use)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (metabolism)
• Vascular Cell Adhesion Molecule-1 (blood)
• Vasodilation (drug effects)
• Vitamin E (administration & dosage, therapeutic use)