Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.

BACKGROUND: There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and ha...

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Main Authors: John, Michelle, Cockcroft, John R., McKeever, Tricia M., Coward, William R., Shale, Dennis J., Johnson, Simon R., Thornton, Jim, Harrison, Timothy W., Knox, Alan J., Bolton, Charlotte E.
Format: Article
Published: Dove Medical Press 2015
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Online Access:https://eprints.nottingham.ac.uk/31826/
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author John, Michelle
Cockcroft, John R.
McKeever, Tricia M.
Coward, William R.
Shale, Dennis J.
Johnson, Simon R.
Thornton, Jim
Harrison, Timothy W.
Knox, Alan J.
Bolton, Charlotte E.
author_facet John, Michelle
Cockcroft, John R.
McKeever, Tricia M.
Coward, William R.
Shale, Dennis J.
Johnson, Simon R.
Thornton, Jim
Harrison, Timothy W.
Knox, Alan J.
Bolton, Charlotte E.
author_sort John, Michelle
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and have anti-inflammatory properties. A proof-of-principle, double-blind, randomized trial determined if 6 weeks of simvastatin 20 mg once daily reduced aortic stiffness and systemic and airway inflammation in patients with chronic obstructive pulmonary disease. METHODS: Stable patients (n=70) were randomized to simvastatin (active) or placebo. Pre-treatment and post-treatment aortic stiffness, blood pressure, spirometry, and circulating and airway inflammatory mediators and lipids were measured. A predefined subgroup analysis was performed where baseline aortic pulse wave velocity (PWV) was >10 m/sec. RESULTS: Total cholesterol dropped in the active group. There was no significant change in aortic PWV between the active group and the placebo group (-0.7 m/sec, P=0.24). In those with aortic stiffness >10 m/sec (n=22), aortic PWV improved in the active group compared with the placebo group (-2.8 m/sec, P=0.03). Neither systemic nor airway inflammatory markers changed. CONCLUSION: There was a nonsignificant improvement in aortic PWV in those taking simvastatin 20 mg compared with placebo, but in those with higher baseline aortic stiffness (a higher risk group) a significant and clinically relevant reduction in PWV was shown.
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spelling nottingham-318262020-05-04T17:00:03Z https://eprints.nottingham.ac.uk/31826/ Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial. John, Michelle Cockcroft, John R. McKeever, Tricia M. Coward, William R. Shale, Dennis J. Johnson, Simon R. Thornton, Jim Harrison, Timothy W. Knox, Alan J. Bolton, Charlotte E. BACKGROUND: There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and have anti-inflammatory properties. A proof-of-principle, double-blind, randomized trial determined if 6 weeks of simvastatin 20 mg once daily reduced aortic stiffness and systemic and airway inflammation in patients with chronic obstructive pulmonary disease. METHODS: Stable patients (n=70) were randomized to simvastatin (active) or placebo. Pre-treatment and post-treatment aortic stiffness, blood pressure, spirometry, and circulating and airway inflammatory mediators and lipids were measured. A predefined subgroup analysis was performed where baseline aortic pulse wave velocity (PWV) was >10 m/sec. RESULTS: Total cholesterol dropped in the active group. There was no significant change in aortic PWV between the active group and the placebo group (-0.7 m/sec, P=0.24). In those with aortic stiffness >10 m/sec (n=22), aortic PWV improved in the active group compared with the placebo group (-2.8 m/sec, P=0.03). Neither systemic nor airway inflammatory markers changed. CONCLUSION: There was a nonsignificant improvement in aortic PWV in those taking simvastatin 20 mg compared with placebo, but in those with higher baseline aortic stiffness (a higher risk group) a significant and clinically relevant reduction in PWV was shown. Dove Medical Press 2015-01-29 Article PeerReviewed John, Michelle, Cockcroft, John R., McKeever, Tricia M., Coward, William R., Shale, Dennis J., Johnson, Simon R., Thornton, Jim, Harrison, Timothy W., Knox, Alan J. and Bolton, Charlotte E. (2015) Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 10 (1). pp. 211-221. ISSN 1178-2005 Chronic obstructive pulmonary disease Arterial stiffness Statins https://www.dovepress.com/cardiovascular-and-inflammatory-effects-of-simvastatin-therapy-in-pati-peer-reviewed-article-COPD doi:10.2147/COPD.S76061 doi:10.2147/COPD.S76061
spellingShingle Chronic obstructive pulmonary disease
Arterial stiffness
Statins
John, Michelle
Cockcroft, John R.
McKeever, Tricia M.
Coward, William R.
Shale, Dennis J.
Johnson, Simon R.
Thornton, Jim
Harrison, Timothy W.
Knox, Alan J.
Bolton, Charlotte E.
Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title_full Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title_fullStr Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title_full_unstemmed Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title_short Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.
title_sort cardiovascular and inflammatory effects of simvastatin therapy in patients with copd: a randomized controlled trial.
topic Chronic obstructive pulmonary disease
Arterial stiffness
Statins
url https://eprints.nottingham.ac.uk/31826/
https://eprints.nottingham.ac.uk/31826/
https://eprints.nottingham.ac.uk/31826/