Article

The purpose of this study was to quantify the effect of statins on
peripheral and coronary endothelial function in patients with and without
established cardiovascular disease. BACKGROUND:
Early atherosclerosis is
characterized by endothelial dysfunction, a known prognostic factor for
cardiovascular disease. RESULTS: The search included MEDLINE, Cochrane Library, Scopus, and EMBASE to identify studies up to 1 December 2009.
Eligible studies were randomized controlled trials on the effects of statins
compared with placebo on endothelial function. Two reviewers extracted data on
study characteristics, methods, and outcomes. Forty-six eligible trials enrolled
a total of 2706 patients: 866 (32%) were women and 432 (16%) had established
cardiovascular disease. Meta-analysis using random-effects models showed
treatment with statins significantly improved endothelial function [standardized
mean difference (SMD) 0.66, 95% CI 0.46-0.85, p < 0.001]. Subgroup analyses
demonstrated statistically significant improvement in endothelial function
assessed both peripherally by flow-mediated dilatation (SMD 0.68, 95% CI
0.46-0.90, p < 0.001) and venous occlusion plethysmography (SMD 0.59, 95% CI
0.06-1.13, p = 0.03) and centrally in the coronary circulation by infusion of
acetylcholine (SMD 1.58, 95% CI 0.31-2.84, p = 0.01). Significant heterogeneity
observed across studies was explained in part by the type of endothelial function
measurement, statin type and dose, and study population differences. Exclusion of
outlier studies did not significantly alter the results. CONCLUSION: Statin
therapy is associated with significant improvement in both peripheral and
coronary endothelial function. The current study supports a role for statin therapy in patients with endothelial dysfunction.

Langue : ANGLAIS

Tiré à part : OUI