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Title: The effects of lipid lowering treatment on the arterial wall and renal function in patients with peripheral arterial disease
Author: Youssef, Fahed
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2006
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Background: Peripheral arterial disease (PAD) is common condition and associated with an increased vascular risk and impaired renal function. Studies have shown a reduction in vascular risk following lipid lowering with a statin in patients with PAD, which may be attributed to a decrease in intima media thickness (IMT) and regression of atherosclerosis. Aims: To study the effect of lipid lowering treatment with statin on patients with peripheral arterial disease. This included monitoring carotid and femoral IMT, renal function and distribution of the enodthelin-1 (ET-1) and its receptors in the arterial wall of patients with advanced PAD.;Materials and Methods: Duplex ultrasound was used to measure the arterial IMT and renal function and renal blood flow (RBF) indices in hyperlipidaemic claudicants before and after short-term atorvastatin treatment. Radioimmunoassay and immunostaining were applied to study ET-1 receptors in segments of popliteal arteries obtained from amputated legs.;Results: There was regression in the carotid and femoral IMT and an improvement in both serum creatinine and urate levels after eight weeks of atorvastatin 20 mg/day (n=25). This improvement in renal function was confirmed after treatment with a different statin (simvastatin) (n=103). Cystatin C, a more sensitive marker, decreased in addition to creatinine and urate in a prospective study (18 patients) after two months of atorvastatin treatment. However, the RBF indices did not change. The distribution of ET-1 receptors in the popliteal arteries from both normo- and hyperlipidaemic patients with advanced PAD (n=12) was also documented.;Conclusions: I am presenting evidence that statin can cause early regression in the IMT and protect renal function. This treatment may also reduce the inflammatory markers in atherosclerotic popliteal arteries.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available