Rosuvastatin Can Reduce Aortic Stiffness in Hypercholesterolemic Patients by Favorable Hemodynamic Changes, Independent of Lipid Lowering and Anti-Inflammatory Effects

초록

Background: Aortic stiffness has been demonstrated as an independent risk predictor for development and prognosis of coronary artery disease.We hypothesized that short term rosuvastatin treatment can reduce aortic stiffness in patients with hypercholesterolemia.methods: Hypercholesterolemic (total cholesterol > 230 mg/dL) patients were prospectively enrolled to rosuvastatin group (10mg/day) andlifestyle modification group. Brachial-ankle pulse wave velocity (baPWV), lipid profiles, hsCRP and metabolic parameters, including fasting bloodglucose, insulin and insulin sensitivity measured by quantitative insulin-sensitivity check index (QUICKI), were measured at baseline and after 2months.results: The rosuvastatin group (n=40; age, 50.1±8.9 years) and lifestyle modification group (n=15; age, 50.4±7.8 years) were well balancedwith respect to clinical characteristics, baPWV, lipid profiles and metabolic parameters. Rosuvastatin group significantly reduced systolic bloodpressure (SBP), diastolic blood pressure (DBP) from baseline (122.5±11.6 vs. 118.0±9.6 mmHg, p=0.005; 77.5±8.7 vs. 73.9±7.6 mmHg, p=0.001),but lifestyle modification didn’t. Of interest, there was a significant reduction of baPWV relative to baseline in rosuvastatin group (1390.3±187.6vs. 1343.1±166.4 cm/sec, p=0.008), but not in lifestyle modification group (1380.4±176.5 vs. 1365.0±200.1 cm/sec, p=0.698). There weresignificant reductions of total cholesterol and LDL cholesterol in both groups. Rosuvastatin therapy also significantly reduced hsCRP from baseline,but lifestyle modification didn’t. Fasting blood glucose, insulin and QUICKI did not differ significantly in both groups. The percent change of baPWVin rosuvastatin group was significantly correlated with the percent change of SBP, DBP or heart rate (r=0.56, p<0.001; r=0.57, p<0.001; r=0.42,p=0.006, respectively) but, not with lipid profiles, metabolic and anti-inflammatory parameters.conclusions: Relative short term rosuvastatin treatment in hypercholesterolemic patients can reduce aortic stiffness by favorable hemodynamicchanges, independent of lipid lowering, metabolic and anti-inflammatory effects.