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Cholesterol lowering with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with coronary artery disease

Coronary flow reserve is mainly influenced by the combination of luminal stenosis and vascular dilation capacity. Thus, after statin treatment, the reduction of ischemic threshold in patients submitted to exercise testing could be intensely influenced by angiographic severity. In this study, we veri... Full description

Journal Title: The American journal of cardiology 2001, Vol.88 (10), p.1134-1138
Main Author: Ramires, Jose Antonio F
Other Authors: Sposito, Andrei C , Mansur, Antonio P , Coelho, Otavio R , Maranhão, Mario , Cesar, Luis Antonio M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Abridged Index Medicus
Adult
Aged
Anticholesteremic Agents - therapeutic use
Biological and medical sciences
Cardiovascular disease
Cholesterol
Coronary Angiography
Coronary Disease - classification
Coronary Disease - complications
Coronary vessels
Exercise Test
Female
General and cellular metabolism. Vitamins
Heart attacks
Humans
Hypercholesterolemia - complications
Hypercholesterolemia - diet therapy
Hypercholesterolemia - drug therapy
Male
Medical research
Medical sciences
Middle Aged
Myocardial Ischemia - etiology
Myocardial Ischemia - prevention & control
Pharmacology. Drug treatments
Pravastatin - therapeutic use
Simvastatin - therapeutic use
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_miscellaneous_72266268
title: Cholesterol lowering with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with coronary artery disease
format: Article
creator:
  • Ramires, Jose Antonio F
  • Sposito, Andrei C
  • Mansur, Antonio P
  • Coelho, Otavio R
  • Maranhão, Mario
  • Cesar, Luis Antonio M
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Anticholesteremic Agents - therapeutic use
  • Biological and medical sciences
  • Cardiovascular disease
  • Cholesterol
  • Coronary Angiography
  • Coronary Disease - classification
  • Coronary Disease - complications
  • Coronary vessels
  • Exercise Test
  • Female
  • General and cellular metabolism. Vitamins
  • Heart attacks
  • Humans
  • Hypercholesterolemia - complications
  • Hypercholesterolemia - diet therapy
  • Hypercholesterolemia - drug therapy
  • Male
  • Medical research
  • Medical sciences
  • Middle Aged
  • Myocardial Ischemia - etiology
  • Myocardial Ischemia - prevention & control
  • Pharmacology. Drug treatments
  • Pravastatin - therapeutic use
  • Simvastatin - therapeutic use
ispartof: The American journal of cardiology, 2001, Vol.88 (10), p.1134-1138
description: Coronary flow reserve is mainly influenced by the combination of luminal stenosis and vascular dilation capacity. Thus, after statin treatment, the reduction of ischemic threshold in patients submitted to exercise testing could be intensely influenced by angiographic severity. In this study, we verify the effect of statin treatment on exercise-induced myocardial ischemia in hypercholesterolemic patients with a broad range of coronary angiographic severities. Patients with 2 consecutive positive exercise tests, coronary stenosis ≥70%, total cholesterol ≥300 mg/dl, and triglycerides ≤200 mg/dl were randomly assigned to a 16-week treatment period with either diet alone (n = 39) or diet plus statins (simavastatin, n = 31 and pravastatin, n = 10). Statin-treated patients had a significant variation in total cholesterol (−46% vs −2.7%; p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-9149
fulltext: fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleCholesterol lowering with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with coronary artery disease
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creatorRamires, Jose Antonio F ; Sposito, Andrei C ; Mansur, Antonio P ; Coelho, Otavio R ; Maranhão, Mario ; Cesar, Luis Antonio M
creatorcontribRamires, Jose Antonio F ; Sposito, Andrei C ; Mansur, Antonio P ; Coelho, Otavio R ; Maranhão, Mario ; Cesar, Luis Antonio M
descriptionCoronary flow reserve is mainly influenced by the combination of luminal stenosis and vascular dilation capacity. Thus, after statin treatment, the reduction of ischemic threshold in patients submitted to exercise testing could be intensely influenced by angiographic severity. In this study, we verify the effect of statin treatment on exercise-induced myocardial ischemia in hypercholesterolemic patients with a broad range of coronary angiographic severities. Patients with 2 consecutive positive exercise tests, coronary stenosis ≥70%, total cholesterol ≥300 mg/dl, and triglycerides ≤200 mg/dl were randomly assigned to a 16-week treatment period with either diet alone (n = 39) or diet plus statins (simavastatin, n = 31 and pravastatin, n = 10). Statin-treated patients had a significant variation in total cholesterol (−46% vs −2.7%; p <0.01), low-density lipoprotein cholesterol (−58% vs 0.8%; p <0.01), and high-density cholesterol (+28% vs −6%; p <0.05) in comparison with the diet-only group. After 16 weeks of treatment, 36 patients (92%) in the diet group still had positive exercise tests, whereas only 7 patients (15%) of the statin group had a positive test (p <0.01). The proportion of positive tests was significantly reduced in subgroups of patients with 1-, 2-, or 3-vessel disease. Regarding the severity of coronary stenosis, the proportion of positive tests was significantly reduced in patients with stenosis between 70% and 90% and in patients with stenosis ≥90%. Moreover, the proportion of positive tests tended to decrease to a greater extent in patients with mild coronary disease. In conclusion, cholesterol-lowering treatment with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with mild or severe epicardial coronary stenosis.
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subjectAbridged Index Medicus ; Adult ; Aged ; Anticholesteremic Agents - therapeutic use ; Biological and medical sciences ; Cardiovascular disease ; Cholesterol ; Coronary Angiography ; Coronary Disease - classification ; Coronary Disease - complications ; Coronary vessels ; Exercise Test ; Female ; General and cellular metabolism. Vitamins ; Heart attacks ; Humans ; Hypercholesterolemia - complications ; Hypercholesterolemia - diet therapy ; Hypercholesterolemia - drug therapy ; Male ; Medical research ; Medical sciences ; Middle Aged ; Myocardial Ischemia - etiology ; Myocardial Ischemia - prevention & control ; Pharmacology. Drug treatments ; Pravastatin - therapeutic use ; Simvastatin - therapeutic use
ispartofThe American journal of cardiology, 2001, Vol.88 (10), p.1134-1138
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descriptionCoronary flow reserve is mainly influenced by the combination of luminal stenosis and vascular dilation capacity. Thus, after statin treatment, the reduction of ischemic threshold in patients submitted to exercise testing could be intensely influenced by angiographic severity. In this study, we verify the effect of statin treatment on exercise-induced myocardial ischemia in hypercholesterolemic patients with a broad range of coronary angiographic severities. Patients with 2 consecutive positive exercise tests, coronary stenosis ≥70%, total cholesterol ≥300 mg/dl, and triglycerides ≤200 mg/dl were randomly assigned to a 16-week treatment period with either diet alone (n = 39) or diet plus statins (simavastatin, n = 31 and pravastatin, n = 10). Statin-treated patients had a significant variation in total cholesterol (−46% vs −2.7%; p <0.01), low-density lipoprotein cholesterol (−58% vs 0.8%; p <0.01), and high-density cholesterol (+28% vs −6%; p <0.05) in comparison with the diet-only group. After 16 weeks of treatment, 36 patients (92%) in the diet group still had positive exercise tests, whereas only 7 patients (15%) of the statin group had a positive test (p <0.01). The proportion of positive tests was significantly reduced in subgroups of patients with 1-, 2-, or 3-vessel disease. Regarding the severity of coronary stenosis, the proportion of positive tests was significantly reduced in patients with stenosis between 70% and 90% and in patients with stenosis ≥90%. Moreover, the proportion of positive tests tended to decrease to a greater extent in patients with mild coronary disease. In conclusion, cholesterol-lowering treatment with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with mild or severe epicardial coronary stenosis.
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3Anticholesteremic Agents - therapeutic use
4Biological and medical sciences
5Cardiovascular disease
6Cholesterol
7Coronary Angiography
8Coronary Disease - classification
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13General and cellular metabolism. Vitamins
14Heart attacks
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16Hypercholesterolemia - complications
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18Hypercholesterolemia - drug therapy
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20Medical research
21Medical sciences
22Middle Aged
23Myocardial Ischemia - etiology
24Myocardial Ischemia - prevention & control
25Pharmacology. Drug treatments
26Pravastatin - therapeutic use
27Simvastatin - therapeutic use
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titleCholesterol lowering with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with coronary artery disease
authorRamires, Jose Antonio F ; Sposito, Andrei C ; Mansur, Antonio P ; Coelho, Otavio R ; Maranhão, Mario ; Cesar, Luis Antonio M
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abstractCoronary flow reserve is mainly influenced by the combination of luminal stenosis and vascular dilation capacity. Thus, after statin treatment, the reduction of ischemic threshold in patients submitted to exercise testing could be intensely influenced by angiographic severity. In this study, we verify the effect of statin treatment on exercise-induced myocardial ischemia in hypercholesterolemic patients with a broad range of coronary angiographic severities. Patients with 2 consecutive positive exercise tests, coronary stenosis ≥70%, total cholesterol ≥300 mg/dl, and triglycerides ≤200 mg/dl were randomly assigned to a 16-week treatment period with either diet alone (n = 39) or diet plus statins (simavastatin, n = 31 and pravastatin, n = 10). Statin-treated patients had a significant variation in total cholesterol (−46% vs −2.7%; p <0.01), low-density lipoprotein cholesterol (−58% vs 0.8%; p <0.01), and high-density cholesterol (+28% vs −6%; p <0.05) in comparison with the diet-only group. After 16 weeks of treatment, 36 patients (92%) in the diet group still had positive exercise tests, whereas only 7 patients (15%) of the statin group had a positive test (p <0.01). The proportion of positive tests was significantly reduced in subgroups of patients with 1-, 2-, or 3-vessel disease. Regarding the severity of coronary stenosis, the proportion of positive tests was significantly reduced in patients with stenosis between 70% and 90% and in patients with stenosis ≥90%. Moreover, the proportion of positive tests tended to decrease to a greater extent in patients with mild coronary disease. In conclusion, cholesterol-lowering treatment with statins reduces exercise-induced myocardial ischemia in hypercholesterolemic patients with mild or severe epicardial coronary stenosis.
copNew York, NY
pubElsevier Inc
pmid11703958
doi10.1016/S0002-9149(01)02048-3