Improvement in Endothelium Dysfunction in Diabetics Treated with Statins: A Randomized Comparison of Atorvastatin 20 mg versus Rosuvastatin 10 mg

Aim: To investigate the effect a 3‐month treatment with atorvastatin 20 mg compared with rosuvastatin 10 mg on endothelium dysfunction in subjects with diabetes. Methods: A total of 22 consecutive subjects with diabetes who were not receiving statins were enrolled in the study. Endothelium function was assessed before treatment (T0), after 1 month (T1), and after 3 months of treatment (T2) with statins with brachial echo‐Doppler test. Patients were randomized to receive atorvastatin 20 mg or rosuvastatin 10 mg. Blood samples were drawn in the meantime in order to evaluate C‐reactive protein (CRP) plasmatic concentrations. Results: A total of 82% of patients enrolled showed endothelium dysfunction (hyperemic reserve <5%). Treatment with statins significantly improved endothelium function in diabetics. Subjects with endothelium dysfunction decreased from 82% (T0) to 44% (T2): mean hyperemic reserve values increased from 2.64% (T0) to 3.23% (T1) and 4% (T2) in patients treated with rosuvastatin (ANOVA P < 0.01), and from 2.74% (T0) to 2.75% (T1) and 4.40% (T2) in those treated with atorvastatin (ANOVA P < 0.01); differences were significant only comparing T2 with T0. Relative increase in endothelium reserve was 51.51% with rosuvastatin versus 60.58% with atorvastatin (P N.S.). Both statins significantly reduced plasmatic levels of CRP (3.18 ± 2.43 mg/dL [T0] vs. 1.31 ± 1.67 mg/dL [T2] with rosuvastatin [P < 0.01], 7.53 ± 7.46 mg/dL [T0] vs. 2.92 ± 2.06 mg/dL [T2] with atorvastatin [P < 0.01]). Relative reduction of CRP levels was −50.57% with rosuvastatin versus −36.28% with atorvastatin (P N.S.). Conclusion: A 3‐month treatment with either atorvastatin 20 mg or rosuvastatin 10 mg is effective in improving endothelium dysfunction in subjects with diabetes.