The Role of Atorvastatin on Monocyte Function in Patients With Coronary Artery Disease and Hypercholesterolemia

Study Overview
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Brief Summary
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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
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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.

Official Title
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Vascular Endothelial Receptor Activity in Patients With Coronary Artery Disease on Medication With Statins

Conditions
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Coronary Artery Disease, Hypercholesterolemia, Monocyte Function

Intervention / Treatment
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* Drug: atorvastatin (drug)


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: atorvastatin (drug)|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HGF+MCP-1-induced monocyte chemotaxis after 1-month treatment with atorvastatin 40 mg or a placebo once a day |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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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