Document Detail

Cholesterol reduction rapidly improves endothelial function after acute coronary syndromes. The RECIFE (reduction of cholesterol in ischemia and function of the endothelium) trial.
MedLine Citation:
PMID:  10385495     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cholesterol lowering reduces coronary events. One mechanism could be improvement of endothelial function. In line with this hypothesis, this study investigates whether cholesterol reduction can result in rapid improvement of endothelial function after acute coronary syndromes. METHODS AND RESULTS: Patients with acute myocardial infarction or unstable angina and total cholesterol levels at admission >/=5.2 mmol/L or LDL >/=3.4 mmol/L were randomized to placebo (n=30) or pravastatin 40 mg daily (n=30) for 6 weeks. Brachial ultrasound was used to measure endothelium-dependent flow-mediated dilatation (FMD) and response to endothelium-independent nitroglycerin. Changes in the levels of markers of platelet activation, coagulation factors, and plasma endothelin levels were also assessed. Total and LDL cholesterol levels were similar at admission and before randomization in both groups. With pravastatin, but not with placebo, they decreased by 23% (P<0.05) and 33% (P<0.01), respectively. FMD was unchanged with placebo, 5.43+/-0.74% (mean+/-SEM) to 5.84+/-0.81%, but increased with pravastatin, 4.93+/-0.81% to 7.0+/-0.79% (P=0.02), representing a 42% relative increase. Responses to nitroglycerin were similar during the time course of the study in the 2 groups. Markers of platelet activity, coagulation factors, and endothelin levels were not affected by pravastatin. CONCLUSIONS: Cholesterol reduction with pravastatin initiated early after acute coronary syndromes rapidly improves endothelial function after 6 weeks of therapy.
J Dupuis; J C Tardif; P Cernacek; P Théroux
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  99     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-16     Completed Date:  1999-07-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3227-33     Citation Subset:  AIM; IM    
Department of Medicine and Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.
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MeSH Terms
Anticholesteremic Agents / therapeutic use*
Blood Pressure / drug effects
Brachial Artery / drug effects,  ultrasonography
Cholesterol / blood*
Confounding Factors (Epidemiology)
Coronary Disease / blood,  etiology*,  physiopathology*,  ultrasonography
Double-Blind Method
Endothelins / blood
Endothelium, Vascular / drug effects*
Heart Rate / drug effects
Hypercholesterolemia / blood,  complications*,  physiopathology*,  ultrasonography
Lipids / blood
Middle Aged
Pravastatin / therapeutic use*
Stroke Volume / drug effects
Vasodilation / drug effects
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Endothelins; 0/Lipids; 57-88-5/Cholesterol; 81093-37-0/Pravastatin
Comment In:
Circulation. 1999 Jun 29;99(25):3215-7   [PMID:  10385491 ]

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