The Role of Atorvastatin on Monocyte Function in Patients With Coronary Artery Disease and Hypercholesterolemia

Condition(s) targeted: Coronary Artery Disease; Hypercholesterolemia; Monocyte Function

Intervention: atorvastatin (drug) (Drug)

Phase: N/A

Status: Completed

Sponsored by: University of Ulm

Official(s) and/or principal investigator(s):
Johannes Waltenberger, MD PhD, Principal Investigator, Affiliation: University of Ulm, Germay

The aim of this study is to determine, whether an intensified atorvastatin therapy can improve monocyte function in patients with coronary artery disease and hypercholesterolemia.

Official title: Vascular Endothelial Receptor Activity in Patients With Coronary Artery Disease on Medication With Statins

Study design: Diagnostic, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Safety Study

Primary outcome:

VEGF-A induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

PlGF-1 induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

HGF-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

MCP-1-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

VEGF-A+MCP-1-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

Secondary outcome: HGF+MCP-1-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day

Detailed description: Hypercholesterolemia is one of the most important cardiovascular risk factors that significantly elevates the risk for the development and progression of arteriosclerotic diseases.

Statins such as atorvastatin have been shown to reduce atherogenic lipoprotein levels as well as cardiovascular morbidity and mortality in a large number of clinical trials. It is suggested that statins have- apart from their lipid-lowering properties- other pleiotropic effects that are responsible for their anti-atheroslerotic and and cardioprotective potential.

Monocytes are crucially involved in the process of arteriogenesis (i. e. the growth of preexisting arterioles). Monocyte chemotaxis can be stimulated with arteriogenic molecules such as vascular endothelial growth factor A (VEGF-A). In previous studies we could demonstrate that the VEGF-A- induced monocyte chemotaxis is severely impaired in hypercholesterolemic patients. This reduced response to VEGF seems to be associated with a decreased ability to form functional collaterals.

Therefore we hypothesize that an intensified therapy with atorvastatin 40 mg once a day can significantly improve monocyte function in patients with coronary artery disease and hypercholesterolemia compared to patients who are only treated with a placebo.

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- coronary artery disease (angiographically proven)

- diagnosis of hypercholesterolemia (either LDL-C ≥ 4 mmol/l or already treated with

lipid-lowering medication)

Exclusion Criteria:

- diabetes mellitus

- uncontrolled arterial hypertension (repeated BP ≥ 160/90 mmHg)

- smoking

- active infections

- acute coronary syndrome (< 8 weeks)

- malignant diseases

- nephropathy

University Hospital Ulm, Ulm 89081, Germany

Related publications:

Waltenberger J, Lange J, Kranz A. Vascular endothelial growth factor-A-induced chemotaxis of monocytes is attenuated in patients with diabetes mellitus: A potential predictor for the individual capacity to develop collaterals. Circulation. 2000 Jul 11;102(2):185-90.

Starting date: May 2002
Ending date: March 2006
Last updated: May 22, 2006