Lipid-lowering, pleiotropic effects of statins and their impact on microcirculation system in patients with type 2 diabetes mellitus who underwent coronary myocardial revascularization

The aim of the study was to assess lipid and carbohydrate metabolism parameters and pleiotropic effects of statins in patients with coronary heart disease (CHD) associated with type 2 diabetes mellitus after coronary myocardial revascularization. This study included 44 CHD patients (mean age of 59.7±6.5) who had sub#compensated type 2 diabetes mellitus. The patients were randomized into two groups. Exercise tolerance, systemic hemodynamics, lipid and carbohydrate metabolism parameters, and microcirculation status were assessed. During the follow up period, patients of the first group (n=24) were taking ACE inhibitors, beta blockers, anticoagulants, and simvastatin (average dose of 16.7±1.4 mg/day); patients of the second group (n=20) were taking ACE inhibitors, beta blockers, anticoagulants, and atorvastatin (average dose of 10.8±0.8 mg/day). After the treatment, patients of the first and second groups showed increment in exercise tolerance by 24.6% and by 24.7%, respectively. The diastolic function improved in both groups, while the systolic function did not change. The basal blood flow increased by 16.1% in the first group and by 13.8% in the second group. After eight weeks of simvastatin therapy, the first group showed significant decrease in total cholesterol (TC) by 21.1%, low#density lipoproteins (LDL) by 28.7%, atherogenic index (AI) by 32.9%, triglycerides (TG) by 16.5%, glucose basal level by 6.3%, and postprandial glycemia by 23.5% (p=0.001). In the second group after atorvastatin therapy, we observed TC decrease by 15.1%, LDL decrease by 23.1%, AI decrease by 35.7%, glucose basal level decrease by 9.8%, and postprandial glycemia decrease by 18.2%. The study showed that eight#week simvastatin therapy at the average dose of 16.7±1.4 mg/day and atorvastatin therapy at the average dose of 10.8±0.8 mg/day in type 2 diabetes mellitus patients resulted in exercise tolerance increase, microcirculation improvement, and positive impact on lipid and carbohydrate metabolism.