Study objectives: Improvement in coronary artery
endothelial function has been demonstrated after cholesterol lowering
in hypercholesterolemic patients with significant atherosclerosis.
However, to our knowledge, no previous study has shown improvement in
resistance artery function in subjects with normal coronary arteries
after cholesterol lowering. The purpose of our study was to investigate
the effect of cholesterol lowering with pravastatin on coronary
resistance artery endothelial function in the setting of
angiographically normal coronary arteries.
Invasive testing of coronary endothelial and vasomotor function was
performed at baseline and after 6 months of pravastatin treatment in
six patients with normal coronary arteriograms.
Results: After 6 months of pravastatin treatment,
low-density lipoprotein cholesterol level dropped from 157 ± 11 to
117 ± 8 mg/dL (p = 0.02) and percent increase in coronary blood
flow after acetylcholine improved from 97 ± 13% to 160 ± 16%
(p = 0.01). There was a trend (p = 0.17) toward enhanced epicardial
dilation in response to acetylcholine after pravastatin treatment when
compared with the baseline study.
study demonstrates significant improvement in coronary resistance
artery endothelial function after 6 months of cholesterol lowering with
pravastatin in six subjects presenting with chest pain who were found
to have normal coronary arteriograms. A trend toward improved
epicardial vasomotion was also observed.