The effects of simvastatin on serum high density lipoprotein cholesterol and endothelial function in patients with coronary artery disease

Objective To investigate the effects of simvastatin on serum high density lipoprotein cholesterol (HDL-C) and endothelial function in patients with coronary artery disease.?Methods Serum lipids and the dilatation changes of brachial artery during reactive hyperemis and after sublingual glyceryl trinitrate (GNT) were measured in 60 patients with coronary artery disease and 30 normal controls. The patients were randomly divided into two groups ( n =30 each): treatment group A (receiving simvastatin 10 mg/d) and non-treatment group B (receiving no simvastatin). After 3 months, serum lipids and the dilatation changes of brachial artery during reactive hyperemis and after GNT were measured and analysed between groups A and B.?Results Before treatment, the dilatation of brachial artery during reactive hyperemis and after GNT showed no significant differences between groups A and B, but the rates of dilation were less than that in the control, being [(2.90±2.83)% vs (8.93± 57.12)%, P 0.05, and (16.35±6.41)% vs (24.65±9.45)%, P 0.05, in group A; and (2.83±2.70)% vs (8.93±5.12)%, P 0.05, and (15.03±7.49)% vs (24.65±9.41)%, P 0.05, in group B.[After 3 months of treatment with simvastatin, the level of HDL-C was higher in group A than in group B ( P 0.05) and the rate of brachial artery dilation during reactive hyperemia in group A was different from that in group B [(5.39±3.81)% vs (3.08±2.95)%, P 0.05].?Conclusions Both endothelium-dependent vasodilation and endothelium-independent vasodilation are impaired in patients with coronary artery disease. HDL-C provides protective effects on endothelium-dependent vasodilation ( r =0.367, P = 0.0061). Simvastatin can increase HDL-C and improve endothelial function.