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Long-term atorvastatin therapy in patients with ischemic heart disease: effect on glycemia and local vascular stiffness

Koshelskaya O. A., Sushkova A. S., Suslova T. E., Ogurkova O. N., Karpov R. S.
Federal State Budgetary Institution, “Research Institute of Cardiology” at the Siberian Branch of Russian Academy of Medical Sciences, Kievskaya 111a, Tomsk 634012

Keywords: arterial stiffness, atorvastatin, coronary heart disease, treatment, diabetes mellitus, subclinical inflammation

DOI: 10.18087/rhj.2013.4.1820

Background. Large-scale studies of recent years have demonstrated that statins, including atorvastatin, can produce a diabetogenic effect and increase the incidence of borderline glycemia. Aim. Studying lipid and anti-inflammatory effects of long-term (9–12 months) atorvastatin therapy and effects of this therapy on carbohydrate metabolism and local vascular stiffness in patients with IHD and DM. Materials and methods. 20 patients with type 2 DM were included in the study. One third of these patients had documented IHD with stable angina and 14 patients had IHD without carbohydrate metabolic disorders. Time courses of blood lipid transport, carbohydrate metabolism, inflammation markers, and common carotid artery (CCA) ultrasound elasticity indices were evaluated during the atorvastatin treatment. Results. In the course of atorvastatin treatment (mean dose, 15.3 mg / day), LDL–C values decreased by 44 % with no changes in apoB / apoA-1. Median hsСRP values decreased from 5.7 (2.5–9.1) to 0.98 (0.5–2.5) mg / l (р<0.05). Basal glycemia and HbA increased from 7.0±0.3 to 7.2±0.3 % (р<0.05) and the CCA wall compliance index decreased from 31.6±1.9×10–3 kPa to 28.4±1.4×10–3 kPa (p<0.01). Conclusion. In patients with IHD and DM, the atorvastatin therapy at the mean dose of 15.3 mg / day exerts pronounced lipid-lowering and anti-inflammatory effects; however at 9–12 months, this therapy is associated with mild hyperglycemia and with increased local stiffness of great arterial walls.
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Koshelskaya O. A., Sushkova A. S., Suslova T. E. et al. Long-term atorvastatin therapy in patients with ischemic heart disease: effect on glycemia and local vascular stiffness. Russian Heart Journal. 2013;12(4):223-229

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