Long-term treatment with atorvastatin improves dyslipidemia and vascular function in patients with primary biliary cirrhosis

T. Stojakovic; C. Putz-Bankuti; H. Scharnagl; M. Wagner; H. Sourij; W. März; T. C. Wascher; M. Trauner

doi:10.1055/s-2008-1081509

Zeitschrift für Gastroenterologie, Table of Contents

Long-term treatment with atorvastatin improves dyslipidemia and vascular function in patients with primary biliary cirrhosis

T Stojakovic ¹, C Putz-Bankuti ², H Scharnagl ¹, M Wagner ², H Sourij ³, W März ¹, TC Wascher ³, M Trauner ²

¹Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
²Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
³Diabetes and Metabolism Outpatient Clinic, Department of Internal Medicine, Medical University of Graz, Graz, Austria

Abstract

Background and aims:

Primary biliary cirrhosis (PBC) is frequently associated with hypercholesterolemia and possibly an increased cardiovascular morbidity and mortality. Statins have the potential to lower serum cholesterol levels and may thus reduce the cardiovascular risk in PBC patients.

The aim of our study was to prospectively examine the safety and efficacy of long-term treatment with low-dose atorvastatin on dyslipidemia, cardiovascular risk factors and vascular function in patients with PBC.

Methods:

Nineteen patients with early stage PBC (biopsy proven and AMA positive) and low-density lipoprotein cholesterol (LDL-C) greater than 130mg/dL were enrolled in this single-centre study and treated with atorvastatin 10mg for one year.

Results:

After 48 weeks of active treatment with atorvastatin 10mg concentrations of total cholesterol and LDL-C decreased by 31% and 38%, respectively (p<0.001). At the beginning of statin therapy there was an increase of alkaline phosphatase which was no longer significant after continuing atorvastatin (“walk-through phenomenon“). No statistical differences in gamma-GT, ALT, AST, bilirubin and IgM serum levels were found. Carotid artery intima-media thickness and vascular wall stiffness did not change, but a significant increase of the flowmediated dilation of the brachial arteries (FMD) up to 17% (p<0.05) was observed after one year statin therapy.

Conclusions:

Long-term treatment with low dose atorvastatin seems to be safe in patients with PBC since no significant increases in serum transaminases were observed. Atorvastatin effectively reduces total cholesterol and LDL-C and improves vascular function as reflected by FMD.