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Rationale:
Apart from their cholesterol lowering effects, statins have cholesterol-independent pleiotropic actions, such as upregulation of 5'-ectonucleotidase and up-regulation of NO-synthase that may increase tolerance against ischemia-reperfusion injury (IR-injury). Several animal studies have shown reduction of IR-injury as a result of statin treatment in both the heart and the kidney. Recently the investigators have shown, using Annexin A5 targeting after voluntary ischemic exercise to assess IR-injury, a protective effect of a 7 day oral rosuvastatin treatment. A three day treatment with atorvastatin however failed to reduce annexin targeting.
Assessment of the flow mediated dilation of the brachial artery as measure of endothelial (dys)function, is a validated model to research effects of possible protective strategies and perform mechanistic experiments on IR-injury in humans in vivo.
The investigators hypothesize that pretreatment with statins can increase endothelial tolerance against ischemia and reperfusion injury.
Objective:
To study the protective effect of pretreatment (both 3 day and 7 day) with rosuvastatin and atorvastatin on flow mediated dilation after 15 minutes ischemia and 15 minutes reperfusion.
Study design: placebo-controlled randomised double-blind trial
Study population: Healthy volunteers, age 18-50
Intervention: Treatment with either rosuvastatin 20 mg, atorvastatin 80mg or placebo during either 3 or 7 days
Main study parameters: Difference in flow mediated dilation before and after 15 minutes ischemia.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Treatment with rosuvastatin or atorvastatin is not expected to harm the volunteers. Most reported side effects of rosuvastatin and atorvastatin are gastro-intestinal complains and myalgia. The volunteers will not benefit directly from participating in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| rosuvastatin 3days | Experimental | 8 Subjects will use rosuvastatin 20 mg/day for 3 days |
|
| atorvastatin 3 days | Active Comparator | 8 Subjects will use atorvastatin 80 mg/day for 3 days.pj |
|
| placebo 3days | Placebo Comparator | 8 Subjects will use placebo for 3 days. |
|
| rosuvastatin 7 days | Experimental | 8 Subjects will use rosuvastatin 20 mg/day for 7 days. |
|
| atorvastatin 7 days | Active Comparator | 8 Subjects will use atorvastatin 80 mg/day for 7 days. |
|
| placebo 7 days | Placebo Comparator | 8 Subjects will use placebo for 7 days. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rosuvastatin | Drug | rosuvastatin 20 mg/day for 3 days. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difference in flow mediated dilation before and after 15 minutes ischemia | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Ecto-5'-nucleotidase activity and lipid profile after statin therapy | 3-7 days |
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Inclusion Criteria:
Exclusion Criteria:
Smoking
History of any cardiovascular disease
Hypertension (in supine position: systole >140 mmHg, diastole >90 mmHg)
Diabetes Mellitus (fasting glucose >7.0 mmol/L or random glucose >11.0 mmol/L)
Hyperlipidaemia (fasting total cholesterol >5.5 mmol/L or random cholesterol >6.5 mmol/L)
Alanine amino transferase >90 U/L
Creatine kinase >440 U/L
Raised rhabdomyolysis risk
Concomitant chronic use of medication
Participation to any drug-investigation during the previous 60 days as checked with VIP check.
Professional athletes
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| RUNMC | Nijmegen | 6500HB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19359665 | Background | Meijer P, Oyen WJ, Dekker D, van den Broek PH, Wouters CW, Boerman OC, Scheffer GJ, Smits P, Rongen GA. Rosuvastatin increases extracellular adenosine formation in humans in vivo: a new perspective on cardiovascular protection. Arterioscler Thromb Vasc Biol. 2009 Jun;29(6):963-8. doi: 10.1161/ATVBAHA.108.179622. Epub 2009 Apr 9. | |
| 11273988 |
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| atorvastatin 3 days | Drug | atorvastatin 80 mg/day for 3 days. |
|
|
| placebo | Drug | placebo for 3 days. |
|
| rosuvastatin 7 days | Drug | rosuvastatin 20 mg/day for 7 days |
|
|
| atorvastatin 7 days | Drug | atorvastatin 80 mg/day for 7 days. |
|
|
| placebo 7 days | Drug | placebo 7 days |
|
| Kharbanda RK, Peters M, Walton B, Kattenhorn M, Mullen M, Klein N, Vallance P, Deanfield J, MacAllister R. Ischemic preconditioning prevents endothelial injury and systemic neutrophil activation during ischemia-reperfusion in humans in vivo. Circulation. 2001 Mar 27;103(12):1624-30. doi: 10.1161/01.cir.103.12.1624. |
| 21885990 | Derived | Wouters CW, Wever KE, Bronckers I, Hopman MT, Smits P, Thijssen DH, Rongen GA. Short-term statin treatment does not prevent ischemia and reperfusion-induced endothelial dysfunction in humans. J Cardiovasc Pharmacol. 2012 Jan;59(1):22-8. doi: 10.1097/FJC.0b013e318232b1a4. |
| ID | Term |
|---|---|
| D015427 | Reperfusion Injury |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000068718 | Rosuvastatin Calcium |
| D000069059 | Atorvastatin |
| ID | Term |
|---|---|
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D005464 | Fluorobenzenes |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011758 | Pyrroles |
| D001393 | Azoles |
| D006538 | Heptanoic Acids |
| D005227 | Fatty Acids |
| D008055 | Lipids |
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