easurements of pulse wave velocity (PWV) are useful for evaluating aortic stiffness, which has been shown to be associated with traditional risk factors. [1][2][3][4][5] Aortic stiffness, but not stiffness of peripheral muscular arteries, also has been noted to predict not only primary coronary events and fatal stroke in a variety of disease conditions, such as end-stage renal disease, 6 hypertension 7 and diabetes, 8 but also cardiovascular mortality in the general population. 9-11 Although conventional techniques for measuring carotid-femoral PWV are non-invasive, sophisticated methods, they are inconvenient, particularly in large clinical trials. Recently, brachial-ankle (ba) PWV has been developed as a more simple, practical, reproducible procedure to assess both the central elastic and peripheral muscular arterial stiffness. 12,13 It has been reported that the baPWV is closely correlated with aortic PWV and leg PWV, 13 is associated with risk factors and organ damage in the presence of cardiovascular diseases, [14][15][16] and has a prognostic value for future cardiovascular events in patients with acute coronary syndrome. 17 Thus, the measurement of baPWV is suitable, especially for screening vascular damage in a large population and when assessing vascular damage in long-term follow-up studies.Recent studies suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (ie, statins) act to exert direct beneficial effects on myocardial ischemia and hypertrophy, coronary vasomotion and vascular smooth muscle cell proliferation, and reduce adverse cardiovascular events in patients at risk through not only the lipid-lowering action but also the lipid-independent anti-atherogenic properties; that is, the so-called pleiotropic effects. Although fluvastatin, but not pravastatin or non-statin antihyperlipidemic agents, has been noted to improve aortic stiffness in association with decreased serum lipid and C-reactive protein (CRP) levels over a treatment period of 12 months, 18 its effect over longer treatment periods has not yet been clarified. Thus, the present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness assessed by PWV in patients with coronary artery disease (CAD) and hyperlipidemia over a much longer treatment period. We also investigated whether arterial stiffness improved in patients whose drugs had been switched from non-statin antihyperlipidemic agents to fluvastatin. Background The present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness, as assessed with pulse wave velocity (PWV), in patients with coronary artery disease (CAD) and hyperlipidemia over the long term.
Methods
Protocol
Methods and ResultsNinety-three patients were randomly assigned to either fluvastatin (group A, n=50) or bezafibrate (group B, n=43) and followed for 5 years. There was no difference in the clinical findings between the 2 groups. In group A, there was a progressive reduction in the brachial-ankle PWV along with a decrease in...
