Different effects of pravastatin and cerivastatin on the media of the carotid arteries as assessed by integrated backscatter ultrasound

Abstract

Background: Currently, there are various types of statins used in the treatment of hyperlipidemia and coronary artery disease. The purpose of this study was to compare the effects of a lipophilic statin (cerivastatin) with those of a hydrophilic statin (pravastatin) on the carotid arterial media using integrated backscatter (IB) ultrasound. Cerivastatin (C) has a strong anti-proliferative effect (APE) on smooth muscle cells (SMCs), whereas pravastatin (P) has a weak effect. Methods and Results: The IB values in the media of 72 segments of carotid arteries were measured in 36 patients with hyperlipidemia before and after statin therapy or diet for 6 months (C, n=13: P, n=12: diet, n=11). In addition, IB values of 34 segments of carotid arteries were measured in 34 patients without coronary risk factors. Intima-media thickness (IMT) and arterial stiffness (stiffness β) were measured by conventional echo at the same time. IB values did not significantly change in the P group (12.8±3.5 vs 12.7±2.7 dB), but decreased in the C group (12.1±2.9 vs 10.0±2.7 dB, p<0.01). Also, stiffness β did not significantly change in the P group (8.3±3.1 vs 7.6±2.5), but decreased in the C group (10.1±4.3 vs 7.9±3.3, p<0.05). IB values correlated with age (r=0.70, p<0.01) and stiffness β (r=0.67, p<0.01) in the 34 patients without coronary risk factors. Conclusions: Statin therapy with cerivastatin, but not pravastatin, decreased the IB values of the carotid media and arterial stiffness. The difference between these 2 statins may be related to their effective dose range.