Clinical study
Atorvastatin decreases vascular endothelial growth factor in patients with coronary artery disease

Parts of the abstract were presented at the American College of Cardiology annual meeting, in Orlando, Florida, in March 2001.
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Abstract

Objectives

The aim of this study was to test a possible influence of atorvastatin on the production of vascular endothelial growth factor (VEGF) in patients with coronary artery disease (CAD) and in vitro.

Background

Vascular endothelial growth factor is suggested to be involved in the growth of atherosclerotic plaque by inducing its neovascularization. Hepatic hydroxymethyl glutaryl-coenzyme A reductase inhibitors (statins) are known to have atheroprotective effects beyond lipid lowering.

Methods

Blood was collected from 14 male hypercholesterolemic patients with angiographically confirmed CAD at baseline and after two months of atorvastatin therapy (20 mg/d) and from eight male control patients. In an ex vivo assay, human coronary artery smooth muscle cells (HCASMC) were incubated with the patient plasma collected before and after atorvastatin therapy. To test the direct effect of atorvastatin on VEGF synthesis in vitro, HCASMC were treated with atorvastatin (1, 3 and 10 μM). The VEGF concentration was measured by enzyme-linked immunosorbent assay.

Results

Atorvastatin therapy reduced VEGF plasma levels in CAD patients (from 31.1 ± 6.1 to 19.0 ± 3.6 pg/ml; p < 0.05). The VEGF plasma concentration tended to be higher in CAD patients before treatment compared to control patients (31.1 ± 6.1 vs. 23.4 ± 3.6 pg/ml; p = NS). Plasma collected before therapy induced significantly more VEGF in HCASMC compared to the plasma collected after treatment and compared to control cells. In vitro, atorvastatin decreased both the basal and the interleukin-1β-induced VEGF release in HCASMC.

Conclusions

These data suggest that atorvastatin may lower the plasma level of VEGF in CAD patients, which could represent a novel beneficial effect of this and perhaps other statins.

Abbreviations

CAD
coronary artery disease
DMSO
dimethyl sulfoxide
EDTA
ethylenediamine-tetraacetic acid
ELISA
enzyme-linked immunosorbent assay
FCS
fetal calf serum
HCASMC
human coronary artery smooth muscle cells
IL
interleukin
LDH
lactate dehydrogenase
LDL
low-density lipoprotein
VEGF
vascular endothelial growth factor

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Dr. Dulak was the recipient of the fellowship of Austrian Society for Cardiology (1999–2001).