Effects of short-term anti-inflammatory therapy on endothelial function in patients with non-ST-segment elevation acute coronary syndrome

The aim was to assess the impact of the short-term anti-inflammatory therapy on coronary endothelial function in non-ST-segment elevation acute coronary syndrome patients. In 30 patients, coronary endothelial function was assessed by acetylcholine test. Vessel response was calculated as a percent change of mean lumen diameter (MLD). Then patients were randomized into three groups: A (n=11) placebo, B (n=11) 80 mg atorvastatin, C (n=8) 80 mg atorvastatin and 25 mg rofecoxib. After 7 days control test was performed. Recovery of coronary endothelial function was calculated as delta in percent changes of MLD between Days 1 and 7. On Day 1, percent change of MLD between baseline and maximum acetylcholine did not differentiate the groups: -20 +/- 3.5% in A, -25 +/- 3.9% in B and -26 +/- 3.7% in C, P=.20. On Day 7, percentage changes in MLD were as follows: -21 +/- 3.9% in A, -15 +/- 3.0% in B and -10 +/- 4.0% in C, P=.002. The delta in percentage change in MLD between Days 1 and 7 were as follows: -1% in A, + 10% in B and +16% in C, P=.02. In conclusion, short-term, anti-inflammatory therapy with high-dose atorvastatin and selective cyclooxygenase-2 inhibitor improves coronary endothelial function within 7 days in non-ST-segment elevation acute coronary syndrome patients. (C) 2011 Elsevier Inc. All rights reserved.