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Statins and Endothelial Function in Patients With Coarctation of the Aorta
This study is enrolling participants by invitation only.
Sponsors and Collaborators: University of California, San Francisco
American Heart Association National Clinical Research Award
Information provided by: University of California, San Francisco
ClinicalTrials.gov Identifier: NCT00767572
  Purpose

Coarctation of the aorta (CoA) accounts for approximately 8% of all congenital heart problems. Patients with CoA are well known to have an increased rates of early heart disease, high blood pressure, heart failure and stroke. Abnormal arterial function (dilation and constriction of the blood vessels) has been observed in these patients and likely contributes to the increased risk of cardiovascular problems. However, therapies targeted at improving arterial function have not been investigated in this population. Statin therapy (cholesterol medicines like Lipitor) have been studied in other subgroups of patients with abnormal arterial function and has shown benefit in improving arterial function and reducing risk of cardiovascular problems.

The investigators hypothesize that patients with CoA have abnormal arterial function leading to increased cardiovascular risk. We further hypothesize that statin therapy may improve this problem. We plan to compile a complete database of information regarding these patients cardiovascular health and propose to then examine the effect of atorvastatin (Lipitor) on arterial function as measured by changes in arm arterial function tests.


Condition Intervention Phase
Coarctation of the Aorta
Drug: atorvastatin
Drug: Sugar pill
Phase IV

MedlinePlus related topics: Statins
Drug Information available for: Atorvastatin Atorvastatin calcium
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Crossover Assignment, Efficacy Study
Official Title: Effects of Statins on Endothelial Function in Patients With Coarctation of the Aorta

Further study details as provided by University of California, San Francisco:

Primary Outcome Measures:
  • Brachial artery reactivity [ Time Frame: August 2008-June 2009 ] [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: August 2008
Estimated Study Completion Date: June 2009
Estimated Primary Completion Date: June 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
atorvastatin: Experimental
Patients are randomized to either atorvastatin or placebo once daily for 12 weeks. There is a 4 week washout, and then the groups are switched for 12 weeks. Brachial artery assessment will be performed before and after each 12 week period on therapy.
Drug: atorvastatin
Atorvastatin 80mg daily vs. placebo daily X 12 weeks, then 4 week washout period, then cross over groups to complete another 12 weeks. (Total study time is 28 weeks (12+4+12)
sugar pill: Placebo Comparator
See above. Patients will be randomized to atorvastatin vs. placebo for 12 weeks and after a 4 week washout period the groups will be switched.
Drug: Sugar pill
atorvastatin 80mg daily vs. placebo daily X 12 weeks, then 4 week washout, then cross over groups X 12 weeks. Total study time is 28weeks (12+4+12).

Detailed Description:

The study design is a randomized double-blind cross over clinical trial. Patients who meet inclusion criteria and no exclusion criteria will be enrolled. They will undergo a baseline cardiovascular assessment including echocardiography, MRI/MRA imaging, serum blood samples, brachial artery reactivity testing, and carotid intimal media thickness testing. Once they have completed their baseline testing, they will be randomized to either atorvastatin 80mg or placebo. They will complete 12 weeks of therapy and return at the end of 12 weeks to have a repeat brachial artery study and serum studies. There will then be a four week washout period where they take no medication. They will return for a follow up visit at the end of that four week period for repeat baseline brachial artery testing and serum studies. They then will be assigned to the opposite agent they were on previously (so if they originally were on placebo they switch to atorvastatin and vice versa). They will complete another 12 weeks of therapy and return at the end for a final brachial artery study and blood testing.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • patients over the age of 18 years with repaired CoA and willing to participate in all portions of the study including follow up, blood draws, urine sample, echocardiogram, MRI, FMD testing, CIMT testing and statin administration.

Exclusion Criteria:

  • patients who are pregnant, nursing, or planning on becoming pregnant in the subsequent year
  • current smokers
  • patients with documented CAD, other systemic inflammatory disorder such as systemic lupus erythematosis or rheumatoid arthritis
  • patients already on statin therapy or who have had previous adverse effects to statin therapy
  • patients with hepatic transaminases >2X the upper limit of normal
  • patients with creatinine clearance <60mg/dL
  • patients who have implanted devices such as pacemakers or defibrillators that preclude MRI testing
  • patients with low blood pressure at baseline (< 90/50)
  • patients who are unwilling or unable to comply with the aforementioned portions of the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00767572

Locations
United States, California
UCSF Medical Center, 505 Parnassus Ave
San Francisco, California, United States, 94143
Sponsors and Collaborators
University of California, San Francisco
American Heart Association National Clinical Research Award
  More Information

Responsible Party: UCSF, Cardiology ( Elyse Foster, MD )
Study ID Numbers: H7151-32792-01
Study First Received: September 24, 2008
Last Updated: October 6, 2008
ClinicalTrials.gov Identifier: NCT00767572  
Health Authority: United States: Food and Drug Administration

Keywords provided by University of California, San Francisco:
Coarctation of the aorta
cross over design
atorvastatin
endothelial function

Study placed in the following topic categories:
Aortic coarctation
Heart Diseases
Cardiovascular Abnormalities
Congenital Abnormalities
Heart Defects, Congenital
Aortic Coarctation
Atorvastatin

Additional relevant MeSH terms:
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Therapeutic Uses
Antilipemic Agents
Enzyme Inhibitors
Cardiovascular Diseases
Anticholesteremic Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009