Effects of Low Dose versus High Dose Statin Therapy on the Changes of Endothelial Function and Carotid Intima-Media Thickness in Patients with Variant Angina.
Level 3 - non-randomized controlled study
Non-randomized or unclear allocation comparative study evaluating two drug doses
PubMed 23837115 · doi:10.4250/jcu.2013.21.2.58
What was done
A comparative study evaluated the effects of low-dose versus high-dose statin therapy on endothelial function and vascular structure in 70 patients with variant angina pectoris. Participants were allocated to either atorvastatin 10 mg daily (group I: n = 35, mean age 54.2 ± 12.5 years) or atorvastatin 40 mg daily (group II: n = 35, mean age 52.6 ± 9.8 years). Brachial artery flow-mediated vasodilation (FMD) and carotid intima-media thickness (IMT) were assessed at baseline and after 6 months of treatment.
What was found
Baseline FMD and carotid IMT were similar between groups. After 6 months of therapy, FMD improved significantly in both groups (from 7.7 ± 2.5% to 8.9 ± 2.2% in group I, p = 0.001; from 7.9 ± 2.7% to 9.5 ± 2.8% in group II, p < 0.001), but the degree of FMD change and 6-month FMD values did not differ significantly between groups. Carotid IMT showed no significant change in either group.
Why it matters
Statin therapy improves endothelial function in patients with variant angina, but escalating atorvastatin from 10 mg to 40 mg provides no additional benefit on vascular function or carotid IMT over 6 months.
Limits
The abstract does not state whether treatment allocation was randomized or blinded. The sample size is small (n = 70), there was no placebo or untreated control group, clinical endpoints such as angina attacks were not evaluated, and 6 months may be too brief to detect carotid IMT regression.
Cited by
- supports Low doses of statins are sufficient to impact vascular inflammation, lower CRP, improve endothelial function, and stabilize arterial plaque without needing high or moderate doses.