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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.

Authors

Michelle John

John R. Cockcroft

TRICIA MCKEEVER tricia.mckeever@nottingham.ac.uk
Professor of Epidemiology and Medical Statistics

William R. Coward

Dennis J. Shale

SIMON JOHNSON simon.johnson@nottingham.ac.uk
Professor of Respiratory Medicine

JIM THORNTON jim.thornton@nottingham.ac.uk
Professor of Obstetrics and Gynaecology

Timothy W. Harrison

Alan J. Knox

Charlotte E. Bolton



Abstract

BACKGROUND:

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.


METHODS:


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.

RESULTS:


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.


CONCLUSION:

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
Electronic ISSN 1178-2005
Publisher Dove Medical Press
Peer Reviewed Peer Reviewed
Volume 10
Issue 1
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
DOI https://doi.org/10.2147/COPD.S76061
Keywords Chronic obstructive pulmonary disease, Arterial stiffness, Statins
Publisher URL https://www.dovepress.com/cardiovascular-and-inflammatory-effects-of-simvastatin-therapy-in-pati-peer-reviewed-article-COPD
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0





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