Coronary Artery Disease, Hypercholesterolemia, Monocyte Function
Conditions
Keywords
statin, atorvastatin, hypercholesterolemia, coronary artery disease, monocyte, collateral formation, arteriogenesis, chemotaxis, migration, growth factors, vascular endothelial growth factor A, placenta growth factor 1, hepatocyte growth factor, monocyte chemotactic protein 1
Brief summary
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.
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.
Interventions
Sponsors
Study design
Eligibility
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
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 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
| Measure | Time frame |
|---|---|
| HGF+MCP-1-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day | — |
Countries
Germany