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Short-Term Effect of Low-Dose Atorvastatin on Haemorrheological Parameters, Platelet Aggregation and Endothelial Function in Patients with Cerebrovascular Disease and Hyperlipidaemia

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Abstract

Introduction and Objective: Haemorrheological parameters and endothelial function are known to be altered in vascular diseases, including stroke. Treatment with HMG-CoA reductase inhibitors (‘statins’) improves cerebrovascular (and cardiovascular) morbidity and mortality in patients with atherosclerosis; the beneficial effects may involve lipid-independent mechanisms. The aim of this study was to assess the short-term effect of low-dose atorvastatin on haemorrheological parameters, platelet aggregation and endothelial dysfunction in patients with chronic cerebrovascular disease and hyperlipidaemia.

Patients and Methods: Twenty-seven patients (mean age 61±8 years) with chronic cerebrovascular disease and hyperlipidaemia were included in the study. Serum lipid levels, haemorrheological parameters (haematocrit, plasma fibrinogen levels, plasma and whole blood viscosity [WBV] and red blood cell [RBC] aggregation and deformability) and platelet aggregation were assessed at baseline and after 1 and 3 months of treatment with atorvastatin (Sortis®) 10 mg/day. von Willebrand factor (vWF) activity (a measure of endothelial function) was measured at baseline and after 1 month of treatment.

Adverse events were recorded at each visit. Physical examinations, haemato-logical assessments and serum and urine chemistry assays were performed during the study.

Results: Plasma total cholesterol levels were reduced by a mean of 27% compared with baseline after both 1 and 3 months of treatment (p < 0.001). Low density lipoprotein-cholesterol levels were reduced by a mean of 40% and 38% (p < 0.001), respectively, after 1 and 3 months of treatment, compared with baseline values. Triglyceride levels decreased by 20% at 1 month and by 10% after 3 months (p < 0.001).

Atorvastatin significantly improved WBV after 3 months of treatment and RBC deformability after 1 month and 3 months of treatment (p < 0.05). Collagen-induced platelet aggregation was significantly decreased at 1 (p < 0.05) and 3 months (p < 0.001) compared with baseline values, despite unaltered antiplatelet therapy. vWF activity was also improved significantly (p < 0.05) after 1 month of treatment.

Conclusions: Our findings show that the beneficial effects of atorvastatin are complex. Besides lipid lowering, atorvastatin can improve haemorrheological parameters, platelet aggregation and endothelial dysfunction after short-term and low-dose therapy. Whether such early laboratory changes translate into clinical utility for secondary stroke prevention awaits the results of endpoint trials.

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Acknowledgements

This study was supported by the Hungarian Research Fund (F030770). The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Authors and Affiliations

  1. Department of Neurology, University of Pecs School of Medicine, Pecs, Hungary

    Laszlo Szapary, Monika Szots & Jozsef Czopf

  2. First Department of Medicine, Division of Cardiology, University of Pecs School of Medicine, Ifjusag ut 13, Pecs, H-7624, Hungary

    Beata Horvath, Zsolt Marton, Tamas Alexy, Gabor Kesmarky, Tamas Habon, Istvan Juricskay &  Kalman Toth

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  1. Laszlo Szapary
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Correspondence to Kalman Toth.

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Szapary, L., Horvath, B., Marton, Z. et al. Short-Term Effect of Low-Dose Atorvastatin on Haemorrheological Parameters, Platelet Aggregation and Endothelial Function in Patients with Cerebrovascular Disease and Hyperlipidaemia. CNS Drugs 18, 165–172 (2004). https://doi.org/10.2165/00023210-200418030-00003

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