Department of Cardiovascular Medicine, Shinshu University School of Health Sciences, Japan.
Circ J. 2011;75(11):2660-7. doi: 10.1253/circj.cj-11-0497. Epub 2011 Aug 20.
The treatment effects of rosuvastatin on arterial stiffness were assessed and compared to those of fluvastatin in high-risk Japanese patients with dyslipidemia in a primary prevention group.
Patients were randomly assigned to either 2.5-5 mg/day of rosuvastatin (Group A) or 20-40 mg/day of fluvastatin (Group B) and followed up for 12 months. In Group A (n=38), there was a progressive reduction in brachial-ankle pulse wave velocity (baPWV) along with a decrease in the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (L/H) ratio and high-sensitivity C-reactive protein (hsCRP), and the change in baPWV correlated significantly with that of the L/H ratio and that of hsCRP after rosuvastatin treatment. In Group B (n=37), although fluvastatin achieved a significant improvement in baPWV, L/H ratio, and hsCRP, baPWV was significantly greater than that in Group A and showed a significant correlation with that of hsCRP alone after fluvastatin treatment. In a subgroup of patients (n=26), switching from fluvastatin to rosuvastatin further improved baPWV and the L/H ratio without altering hsCRP after 12 months.
Low-dose rosuvastatin would be more effective than fluvastatin in improving arterial stiffness in high-risk Japanese patients with dyslipidemia. The results suggest that improvement in arterial stiffness by rosuvastatin mainly depends on its strong lipid-lowering effects, whereas that by fluvastatin is strongly dependent on the pleiotropic effects, especially an anti-inflammatory action.
在血脂异常的高危日本患者一级预防人群中,评估了瑞舒伐他汀对动脉僵硬的治疗效果,并与氟伐他汀进行了比较。
患者被随机分配至每天 2.5-5mg 的瑞舒伐他汀(A 组)或每天 20-40mg 的氟伐他汀(B 组),并随访 12 个月。在 A 组(n=38)中,随着低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(L/H)比值和高敏 C 反应蛋白(hsCRP)的降低,肱踝脉搏波速度(baPWV)逐渐降低,瑞舒伐他汀治疗后 baPWV 的变化与 L/H 比值和 hsCRP 的变化显著相关。在 B 组(n=37)中,虽然氟伐他汀可显著改善 baPWV、L/H 比值和 hsCRP,但 baPWV 仍显著高于 A 组,且氟伐他汀治疗后仅与 hsCRP 显著相关。在亚组患者(n=26)中,在转换为瑞舒伐他汀治疗 12 个月后,baPWV 和 L/H 比值进一步改善,而 hsCRP 没有改变。
在血脂异常的高危日本患者中,小剂量瑞舒伐他汀比氟伐他汀更能有效改善动脉僵硬。结果表明,瑞舒伐他汀改善动脉僵硬主要依赖于其强大的降脂作用,而氟伐他汀则强烈依赖于其多效性作用,特别是抗炎作用。