Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
John, Michelle; Cockcroft, John R.; McKeever, Tricia M.; Coward, William R.; Shale, Dennis J.; Johnson, Simon R.; Thornton, Jim; Harrison, Timothy W.; Knox, Alan J.; Bolton, Charlotte E.
John R. Cockcroft
TRICIA MCKEEVER email@example.com
Professor of Epidemiology and Medical Statistics
William R. Coward
Dennis J. Shale
SIMON JOHNSON firstname.lastname@example.org
Professor of Respiratory Medicine
JIM THORNTON email@example.com
Professor of Obstetrics and Gynaecology
Timothy W. Harrison
Alan J. Knox
Charlotte E. Bolton
There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and have anti-inflammatory properties. A proof-of-principle, double-blind, randomized trial determined if 6 weeks of simvastatin 20 mg once daily reduced aortic stiffness and systemic and airway inflammation in patients with chronic obstructive pulmonary disease.
Stable patients (n=70) were randomized to simvastatin (active) or placebo. Pre-treatment and post-treatment aortic stiffness, blood pressure, spirometry, and circulating and airway inflammatory mediators and lipids were measured. A predefined subgroup analysis was performed where baseline aortic pulse wave velocity (PWV) was >10 m/sec.
Total cholesterol dropped in the active group. There was no significant change in aortic PWV between the active group and the placebo group (-0.7 m/sec, P=0.24). In those with aortic stiffness >10 m/sec (n=22), aortic PWV improved in the active group compared with the placebo group (-2.8 m/sec, P=0.03). Neither systemic nor airway inflammatory markers changed.
There was a nonsignificant improvement in aortic PWV in those taking simvastatin 20 mg compared with placebo, but in those with higher baseline aortic stiffness (a higher risk group) a significant and clinically relevant reduction in PWV was shown.
|Journal Article Type||Article|
|Publication Date||Jan 29, 2015|
|Journal||International Journal of Chronic Obstructive Pulmonary Disease|
|Publisher||Dove Medical Press|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||John, M., Cockcroft, J. R., McKeever, T. M., Coward, W. R., Shale, D. J., Johnson, S. R., …Bolton, C. E. (2015). Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 10(1), doi:10.2147/COPD.S76061|
|Keywords||Chronic obstructive pulmonary disease, Arterial stiffness, Statins|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0|
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0
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