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Cardiovascular Research 2001 50(3):577-582; doi:10.1016/S0008-6363(01)00227-9
© 2001 by European Society of Cardiology
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Copyright © 2001, European Society of Cardiology

Effect of statin versus fibrate on postprandial endothelial dysfunction: role of remnant-like particles

Hanneke W Wilminka, Marcel B Twicklera, Jan Dirk Bangaa, Geesje M Dallinga-Thiea, Hans Eeltinkb, D.Willem Erkelensa, Ton J Rabelinka and Erik S Stroesa,*

aDepartment of Vascular Medicine, F02.126, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
bMedical Department, Bayer Netherlands, Mijdrecht, The Netherlands

* Corresponding author. Tel.: +31-302-509-111; fax: +31-302-543-492 e.stroes{at}digd.azu.nl

Background: Postprandial lipemia is associated with endothelial dysfunction. Remnant-like particles (RLP) have been suggested to contribute to these adverse vascular effects. We investigated the effect of cerivastatin and gemfibrozil upon oral fat load induced changes in endothelial function and postprandial lipid profile in vivo. Methods: In a randomized cross-over trial, 15 healthy volunteers received cerivastatin (0.4 mg once daily), gemfibrozil (900 mg once daily) or placebo for 3 weeks. Lipid profiles and flow mediated dilation (FMD) were assessed before and 4 h after an oral fat load. Endothelium-independent dilation was tested after nitroglycerine 0.4 mg sublingual spray. Results: After the placebo period, the oral fat load induced an increase in triglycerides (TG) and RLP-cholesterol (RLP-C) (0.9±0.7 and 0.08±0.04 mmol/l, respectively) and a significant decrease in FMD (9.1±3.4 to 4.3±3.3%, P<0.05). After gemfibrozil, TG increase was attenuated (0.5±0.5 mmol/l), whereas RLP-C increase (0.05±0.09 mmol/l) and FMD decrease (9.0±3.8 to 5.2±2.6%, P<0.05) were not different from placebo therapy. Cerivastatin did not affect TG increase (0.7±0.8 mmol/l). RLP-C increase (0.02±0.07 mmol/l) and FMD (7.9±2.6 to 8.4±2.8%) change were attenuated significantly compared to placebo. Endothelium-independent vasodilatation remained unaltered throughout the protocol. Conclusion: Cerivastatin, but not gemfibrozil significantly reduces RLP-C increase after an oral fat load in combination with a reversal of fat-load induced endothelial dysfunction. The present data imply that lowering of RLP-C, rather than lowering of total TG levels, may contributes to the prevention of endothelial dysfunction after an oral fat load during statin use.

KEYWORDS Endothelial function; Statins; Vasoconstriction/dilation


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