The Effects After With Drawal Of Atorvastain On Brachial Artery Endothelial Function In Patient With Coronary Heart Disease And Hypercholesterolemia

Objective:To abserve the effects after withdrawal of atrovastain on vascular endothelial function and blood lipid level in patient with coronary heart disease or hypercholesterolemia.Sequentialy,we investigated the frequent problem in clinical practice on withdrawal of statins therapy.Method:Choosing 176 patients from clinic or ward in Qingdao Municipal Medical Group during October 2007 to April 2008 under study.Dividing these patients into four groups,42 patients with hypercholesterolemia as group A;46 patients with diabetes mellitus as group B;38 patients with hypertension as group C; 50 patients with hypercholesterolemia and coronary heart disease as group D.The general conditions as age,body mass index,waist hip ratio,systolic blood pressure, diastolic blood pressure are examined.NO,ET levels and other biochemical variables including total cholesterol,triglyceride,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol are determined after dose four weeks,before dose and after withdrawal two weeks.Results:Atrovastain treatment reduced low density lipoprotein cholesterol (LDL-c) and total cholesterol(TC) levels and improved vascular endothelial function in patients after 4 weeks(P＜0.01).After terminating atorvastain treatment,serum NO levels decreased as well as plasma ET and serum LDL-c levels increased (P＜0.01).serum NO levels lower than the levels before dose(P＜0.05),and plasma ET higher than the levels before dose(P＜0.05).Conclusion:Abrupt withdrawal of atorvastain therapy resulted in the significant adverse impact on brachial artery endothelial function in patients with coronary heart disease and hypercholesterolemia.Termination of therapy may suppress endothelial NO production and impair endothelial function that is independent of lipid-lowering effect.The effect of withdrawal in patients with coronary heart disease and hypercholesterolemia was more serious than sole hypercholesterolemia or coronary heart disease.