Brief Report Fluvastatin prevents development of arterial stiffness in haemodialysis patients with type 2 diabetes mellitus

Background. Arterial stiffness assessed by pulse wave velocity (PWV) predicts all-cause and cardiovascular mortality in diabetic patients with end-stage renal disease. We studied the preventive effects of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, fluvastatin, on arterial PWV values in this population. Methods. Twenty-two patients with normal serum lipid levels received fluvastatin (20 mguday p.o.) or a placebo for 6 months. Their serum lipid levels, serum levels of C-reactive protein (CRP), arterial PWV, and ankle brachial indexes (ABI) were determined before, and 3 and 6 months after taking the medication to evaluate arterial stiffness. Results. At the beginning of the follow-up, there were no differences in age, blood pressure, body mass index, serum haemoglobin A1c level, serum CRP level, serum lipid levels, PWV or ABI between the placebo(ns10) and the fluvastatin-treated patients (ns12). After 6 months, the PWV and the serum oxidized low-density lipoprotein cholesterol (LDL-C) level increased significantly (from 1969"140 to 2326"190 cmus and 70.4"13.8 to 91.8"15.5 Uul, respectively) in the placebo-treated patients. However, the fluvastatin group had a significantly reduced PWV (from 1991"162 to 1709"134 cmus), oxidized LDL-C serum levels (from 89.0"9.6 to 73.0"5.8 Uul) and CRP serum levels (from 0.97"0.32 to 0.26"0.16 mgudl) compared with those in the placebo group. Conclusions. Long-term administration of fluvastatin prevents further worsening of arterial biomechanics in haemodialysis patients with type 2 diabetes mellitus, even in the presence of serum lipid levels in the normal range.