Simvastatin influence on carotid atherosclerotic disease regression

Abstract

Introduction. The measurement of intima-media thickness (IMT) of carotid arteries has emerged as the method of choice for determining the anatomic extent of atherosclerosis and assessing cardiovascular progression. Statins are used in the primary and secondary prevention of cardiovascular and cerebrovascular disorders so as to reduce morbidity and mortality. Objective. To evaluate the effects of treatment with simvastatin in patients with elevated cholesterol levels and increased values of carotid arteries IMT. Methods. The study of 275 patients (155 male and 115 female, aged 37-79 years, mean 60.86 years) was performed from January 2008 - January 2010 at the Vascular and Endovascular Surgery Clinic of the Clinical Centre of Serbia. All patients were treated with simvastatin administered once a day for 6 months. Results. Simvastatin treatment resulted in a statistically signuficant decrease of the IMT thickness of the right common carotid artery. There was no statistically significant reduction in the IMT of the left common carotid artery as well as in the IMT of the right and left internal carotid arteries. Conclusion. Long-term simvastatin treatment results in the regression or slowing down atherosclerosis in symptomatic, as well as in asymptomatic patients with a lower grade of carotid stenosis (IMT below 2.5 mm).Uvod. Merenje debljine intimomedijalnog kompleksa (engl. intima-media thickness - IMT) karotidnih arterija jeste savremena, brza i pouzdana dijagnosticka metoda koja se siroko primenjuje u proceni rasirenosti i napredovanja aterosklerotskog procesa. Statini se primenjuju u primarnoj i sekundarnoj prevenciji kardiovaskularnih i cerebrovaskularnih bolesti radi smanjenja morbiditeta i mortaliteta bolesnika. Cilj rada. Cilj studije bio je da se proceni efikasnost primene simvastatina na stenozantnu bolest karotidnih arterija kod osoba s hiperholesterolemijom. Metode rada. Istrazivanje je trajalo od januara 2008. do januara 2010. godine, a izvedeno je na Klinici za vaskularnu hirurgiju Klinickog centra Srbije. Svi ispitanici su leceni simvastatinom, koji se primenjivao jedanput dnevno. Rezultati. Lecenje simvastatinom je dovelo do statisticki znacajnog smanjenja IMT u desnoj zajednickoj karotidnoj arteriji. Nije zabelezeno statisticki znacajno smanjenje IMT u levoj zajednickoj karotidnoj arteriji, niti u obe unutrasnje karotidne arterije. Zakljucak. Utvrdjeno je da dugotrajna primena simvastatina dovodi do regresije ili usporava napredovanje aterosklerotskog procesa kod simptomatskih i asimptomatskih bolesnika sa stenozom karotidnih arterija nizeg stepena (sa vrednostima IMT manjim od 2,5 mm).