{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T22:45:37Z","timestamp":1759099537197},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,6,10]],"date-time":"2013-06-10T00:00:00Z","timestamp":1370822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A family history of premature coronary artery disease (<jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>) is a well\u2010known risk factor for cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Atorvastatin may improve endothelial dysfunction (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>) in the first\u2010degree relatives (<jats:styled-content style=\"fixed-case\">FDRs<\/jats:styled-content>) of patients with premature <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010five <jats:styled-content style=\"fixed-case\">FDRs<\/jats:styled-content> (median age, 52 years [interquartile range (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>), 46\u201357 years], 21 male) of patients with premature <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> were recruited in a prospective trial with a crossover double\u2010blind design: 6 weeks of treatment with atorvastatin 40 mg\/day followed by placebo, or vice versa. After each treatment, the digital pulse wave amplitude was determined by <jats:styled-content style=\"fixed-case\">EndoPAT<\/jats:styled-content> to obtain the reactive hyperemia index (<jats:styled-content style=\"fixed-case\">RHI<\/jats:styled-content>), a measure for endothelial function. The primary outcome was the difference of <jats:styled-content style=\"fixed-case\">RHI<\/jats:styled-content> between atorvastatin and placebo treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Low\u2010density lipoprotein cholesterol was lower after atorvastatin compared with placebo treatment (124 [102\u2013145] mg\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content> vs 67 [50\u201373] mg\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content>, <jats:italic>P<\/jats:italic> &lt; 0.001). However, <jats:styled-content style=\"fixed-case\">RHI<\/jats:styled-content> was not different after atorvastatin compared with placebo treatment (1.9 [1.5\u20132.4] vs 1.9 [1.6\u20132.2], <jats:italic>P =<\/jats:italic> 0.902). Also, the augmentation index was similar after each treatment. These results were observed both in subjects who had indications for statin treatment (31%) and those who did not (69%) according to National Cholesterol Education Program Adult Treatment Panel <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite improvement in the lipid profile, atorvastatin failed to improve <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">FDRs<\/jats:styled-content> of patients with premature <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>. Although we identified those with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">FDRs<\/jats:styled-content> of patients with premature <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> as a high\u2010risk group for future cardiovascular events, atorvastatin treatment may not be a beneficial primary prevention strategy for this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22152","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T00:56:38Z","timestamp":1370912198000},"page":"480-485","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Atorvastatin Treatment in First\u2010Degree Relatives of Patients With Premature Coronary Artery Disease With Endothelial Dysfunction: A Double\u2010Blind, Randomized, Placebo\u2010Controlled Crossover 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