Intensive treatment with atorvastatin reduces inflammation in mononuclear cells and human atherosclerotic lesions in one month

Background and Purpose - To investigate the effect of short-term high-dose atorvastatin on blood and plaque inflammation in patients with carotid stenosis. Methods - Twenty patients undergoing carotid endarterectomy without previous statin treatment were randomized to receive either atorvastatin 80 mg/d ( n = 11) or no statins ( n = 9) for 1 month. We studied inflammatory mediators in plasma ( enzyme-linked immunosorbent assay), peripheral blood mononuclear cells (PBMCs; quantitative RT-PCR and EMSA) and plaques ( immunohistochemistry and Southwestern histochemistry). Results - Atorvastatin significantly decreased total and low-density lipoprotein cholesterol and prostaglandin E-2 plasma levels. PBMCs from treated patients showed impaired NF-kappa B activation and MCP-1 and COX-2 mRNA expression. Carotid atherosclerotic plaques demonstrated a significant reduction in macrophage infiltration, activated NF-kappa B, and COX-2 and MCP-1 expression. Conclusions - Intensive treatment with atorvastatin decreases inflammatory activity of PBMCs and carotid atherosclerotic plaques in 1 month. These data strongly suggest that the antiinflammatory effect of high doses of statins in humans can be seen very early.