Rapid improvement of nitric oxide bioavailability after lipid-lowering therapy with cerivastatin within two weeks
Stefan John, MDa,
Christian Delles, MDa,
Johannes Jacobi, MDa,
Markus P. Schlaich, MDa,
Markus Schneider, MDa,
Gerd Schmitz, MDb and
Roland E. Schmieder, MD, FACCa
a Department of Medicine IV, University of Erlangen-Nürnberg, Klinikum Nürnberg-Süd, Nürnberg, Germany
b Department of Clinical Chemistry and Laboratory Medicine, University of Regensburg, Regensburg, Germany

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Figure 1 Impaired endothelium-dependent vasodilation in patients with hypercholesterolemia in comparison with controls. Increase in forearm blood flow (ml/min/100 ml) after the infusion of increasing doses of acetylcholine in patients with hypercholesterolemia (n = 35, solid circle) and in healthy controls (n = 19, solid box) (**p < 0.01, *p < 0.05).
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Figure 2 Improved endothelium-dependent vasodilation after two weeks of cerivastatin. Increase in forearm blood flow in percent from baseline ( %) after the infusion of acetylcholine with increasing doses in the cerivastatin group (n = 17, open circle = before therapy, solid circle = after therapy) and the placebo group (n = 18, open box = before therapy, solid box = after therapy). Comparison of the changes between treatment group and placebo (*p < 0.05, **p < 0.01; analysis of variance [ANOVA] p < 0.05).
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Figure 3 Unaffected endothelium-independent vasodilation after two weeks of cerivastatin. Increase in forearm blood flow in percent from baseline ( %) after the infusion of nitroprusside with increasing doses in the cerivastatin group (n = 17, open circle = before therapy, solid circle = after therapy) and the placebo group (n = 18, open box = before therapy, solid box = after therapy). Comparison of the changes between the treatment group and placebo (all NS).
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Figure 4 Improved endothelium-dependent vasodilation after cerivastatin therapy can be blocked with L-NMMA. Changes in forearm blood flow in percent from baseline ( %) after the infusion of acetylcholine (ACh) 12 µg/min (ACh 12, upper panel) and 48 µg/min (ACh 48, lower panel) without (left two columns) and with (right two columns) coinfusion of the nitric oxide synthase inhibitor L-NMMA 4 µmol/min before (open box) and after (solid box) lipid-lowering therapy with cerivastatin for two weeks. L-NMMA = N(G)-monomethyl-L-arginine.
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