Short-Term Effect of Atorvastatin on Carotid Artery Elasticity A Pilot Study

• Published in: Stroke (1970) Vol. 42; no. 12; pp. 3460 - 3464
• Main Authors: Ratchford, Elizabeth V., Gutierrez, Jose, Lorenzo, Dalia, McClendon, Mark S., Della-Morte, David, DeRosa, Janet T., Elkind, Mitchell S.V., Sacco, Ralph L., Rundek, Tatjana
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.12.2011
• Subjects: Aged; Aged, 80 and over; Atorvastatin; Biological and medical sciences; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - drug therapy; Carotid Arteries - diagnostic imaging; Carotid Arteries - drug effects; Elasticity - drug effects; Female; Heptanoic Acids - pharmacology; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Medical sciences; Middle Aged; Neurology; Neurosurgery; Pilot Projects; Pyrroles - pharmacology; Pyrroles - therapeutic use; Skull, brain, vascular surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Ultrasonography; Vascular diseases and vascular malformations of the nervous system; Short term; Stroke; Nervous system diseases; Enzyme; elasticity; Enzyme inhibitor; Cardiovascular disease; Statin derivative; carotid arteries; carotid ultrasound; Hypocholesterolemic agent; Cerebral disorder; Vascular disease; HMG-CoA reductase inhibitor; Carotid; statins; Central nervous system disease; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; Oxidoreductases; Ultrasound; Cerebrovascular disease; Antilipemic agent
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.111.625418

Few studies have examined the early effects of statins on carotid artery elasticity, a potential surrogate marker of cardiovascular risk. This study examined the short-term effects of atorvastatin 80 mg daily on carotid elasticity measured by high-resolution B-mode ultrasound. The study included 40 stroke-free and statin-naive subjects older than age 45 (mean age, 70±7 years; 55% men; 64% Caribbean-Hispanic). Outcome measures included carotid stiffness indices at 14 and 30 days after initiation of treatment. The systolic and diastolic diameters of the right common carotid artery were averaged from multiple B-mode imaging frames. Absolute and relative changes of strain [(systolic diameter-diastolic diameter)/diastolic diameter], stiffness (β) [ln (systolic/diastolic blood pressure)/strain], and distensibility (1/β adjusted for wall thickness) from baseline were compared by the repeated measures t test and were considered significant at α=0.05. Baseline mean stiffness was 0.08 (95% confidence interval [CI], 0.06-0.10). It significantly decreased at day 30 to 0.05 (CI, 0.04-0.06; P<0.01). Mean baseline distensibility was 15.25 (CI, 13.18-17.32), increasing significantly at day 30 to 17.23 (CI, 14.01-20.45; P<0.05). An improvement in distensibility of ≥10% from baseline was observed in 29 (73%) subjects. Changes in stiffness and distensibility were maximal among subjects with baseline low-density lipoprotein levels<130 mg/dL. Short-term treatment with high-dose atorvastatin was associated with improvement in the carotid elasticity metrics. Carotid artery elasticity measured by B-mode ultrasound is a simple noninvasive measure of arterial wall function and may be a useful surrogate end point in clinical trials targeting individuals at increased risk for atherosclerosis.