Atorvastatin therapy improves exercise oxygen uptake kinetics in post-myocardial infarction patients

• Published in: European journal of clinical investigation 2007-06, Vol.37 (6), p.454-462
• Main Authors: Guazzi, M., Tumminello, G., Reina, G., Vicenzi, M., Guazzi, M. D.
• Format: Article
• Language: English
• Subjects: Anticholesteremic Agents - blood; Anticholesteremic Agents - therapeutic use; Atorvastatin Calcium; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Disease; Coronary heart disease; Echocardiography - methods; Endothelium; exercise; Exercise Test - methods; Female; General aspects; Heart; Heptanoic Acids - blood; Heptanoic Acids - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - drug therapy; Myocardial Infarction - metabolism; Oxygen Consumption; oxygen kinetics; Pyrroles - blood; Pyrroles - therapeutic use; statin
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1111/j.1365-2362.2007.01805.x

Background  Statins represent a modern mainstay of the drug treatment of coronary artery disease and acute coronary syndromes. Reduced aerobic work performance and slowed VO2 kinetics are established features of the clinical picture of post‐myocardial infarction (MI) patients. We tested the hypothesis that statin therapy improves VO2 exercise performance in normocholesterolaemic post‐MI patients. Materials and methods  According to a double‐blinded, randomized, crossover and placebo‐controlled study design, in 18 patients with uncomplicated recent (3 days) MI we investigated the effects of atorvastatin (20 mg day−1) on gas exchange kinetics by calculating VO2 effective time constant (tau) during a 50‐watt constant workload exercise, brachial artery flow‐mediated dilatation (FMD) as an index of endothelial function, left ventricular function (echocardiography) and C‐reactive protein (CRP, as an index of inflammation). Atorvastatin or placebo was given for 3 months each. Results  Atorvastatin therapy significantly improved exercise VO2 tau and FMD, and reduced CRP levels. We did not observe changes in cardiac contractile function and relaxation properties during all study periods in either group. Conclusions  In post‐MI patients exercise performance is a potential additional target of benefits related to statin therapy. Endothelial function improvement is very likely implicated in this newly described therapeutic property.