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Cited by 451Lipoproteins and Cardiovascular HealthNitric Oxide and Endothelin EffectsCardiovascular Health and Disease Prevention

Beneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolaemic patients

Leung, W.-H., Lau, C.-P., Wong, C.-K.·1993·The Lancet
DOI 10.1016/0140-6736(93)90634-s
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Abstract

Since hypercholesterolaemia is associated with impaired endothelium-dependent vasodilation, a study was conducted to find out whether cholesterol reduction will improve endothelial function in patients with hypercholesterolaemia and normal coronary arteries. 25 men (mean age 51 [SD 8] years) with total serum cholesterol > 6.2 mmol/L) and angiographically normal coronary arteries had their coronary vasomotor responses to intracoronary acetylcholine and nitroglycerin assessed by computer-assisted quantitative angiography at baseline and after 6 months of cholesterol-reducing diet and cholestyramine. Between baseline and follow-up mean total serum cholesterol level fell by 28.7 (SD 5.6)% (p < 0.001); mean low-density lipoprotein (LDL) cholesterol level by 35.6 (8.7)% (p < 0.001); and mean total cholesterol to high-density lipoprotein (HDL) cholesterol ratio by 29.4 (10.6)% (p < 0.001). Acetylcholine significantly reduced the mean segment diameter at baseline, by 21.7 (14.0)% (p < 0.01), but it increased the diameter at follow-up, by 6.16 (13.3)% (p < 0.01), the difference between the two occasions being significant (p < 0.001). Nitroglycerin significantly increased the mean segment diameter, both at baseline, by 18.7 (11.5)% (p < 0.01), and at follow-up, by 19.3 (12.1)% (p < 0.01), the difference between the two responses being not significant. At baseline total cholesterol and LDL cholesterol did not correlate with acetylcholine response, but they did at follow-up (total cholesterol, r = 0.67, p < 0.01; LDL cholesterol, r = 0.64, p < 0.01). Impairment of endothelium-dependent (acetylcholine-induced) dilation of the epicardial coronary arteries in hypercholesterolaemic patients with angiographically normal coronary arteries is thus reversible by reducing serum cholesterol. In addition, the degree of impairment of acetylcholine-induced vasomotor response is related to the cholesterol concentrations after therapy.

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Authors
Leung, W.-H., Lau, C.-P., & Wong, C.-K.
Affiliations
Queen Mary Hospital (CN)
Corresponding author
Leung, W.-H.
ORCID
Lau, C.-P.
Venue
The Lancet
Publisher
Elsevier BV
Published
1993-06
Volume
341
Issue
8859
Pages
1496-1500
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/0140-6736(93)90634-s
OpenAlex
W1971261277
Cited by
451
References
38
Citations by year
2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 2 · 2012: 4
FWCI
40.12
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
endothelium-dependent vasodilation, coronary endothelial function, nitroglycerin, cholestyramine, cholesterol-lowering diet, LDL cholesterol, HDL cholesterol, serum cholesterol reduction, coronary arteries
MeSH terms
Acetylcholine, Adult, Aged, Cholesterol, Cholestyramine Resin, Coronary Vessels, Endothelium, Vascular, Nitroglycerin, Humans, Hypercholesterolemia, Cholesterol, LDL, Male, Middle Aged, Vasodilation, Coronary Angiography

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