2003 年 67 巻 10 号 p. 866-870
The short- and intermediate-term pleiotropic effects of atorvastatin were investigated in 18 hypercholesterolemic patients, as well as the temporal differences in these pleiotropic effects. Atorvastatin was given for 3 months and fasting lipid concentrations, thiobarbituric acid reactive substances (TBARS), fibrinolytic parameters, and flow-mediated dilation of the brachial artery (FMD) were measured at baseline and after 2 weeks and 3 months of therapy. Atorvastatin reduced the total cholesterol (273±34 vs 188±31 mg/dl, p<0.0001), low-density lipoprotein-cholesterol (LDL-C: 174±28 vs 111±23 mg/dl, p<0.0001), small, dense LDL-C (34±22 vs 18±20%, p<0.01), remnant-like particles cholesterol (RLP-C: 8.8±6.0 vs 5.1±2.6 mg/ml, p<0.01), and TBARS (3.3±1.0 vs 3.1±0.9 nmol/ml, p<0.05) after 2 weeks. Atorvastatin decreased the concentration of small, dense LDL-C again after 3 months (8±13%, p<0.0001). The plasma concentrations of the fibrinolytic parameters did not change significantly after 3 months of atorvastatin therapy. FMD increased significantly after 2 weeks (5.6±2.1 vs 6.3±2.0%, p<0.01) and additionally increased after 3 months of therapy (8.3±1.9%, p<0.0001). There were no correlations between the pleiotropic effects and the improvement in the lipid profile. The results indicate some short-term pleiotropic effects of atorvastatin therapy within 2 weeks, which may be important with respect to the early benefits of statin therapy. (Circ J 2003; 67: 866 - 870)
