Add-on therapy of EPA reduces oxidative stress and inhibits the progression of Aortic stiffness in patients with coronary artery disease and statin therapy: A randomized controlled study

Aim: we examined the anti-oxidant mechanisms of combined therapy of eicosapentaenoic acid (epa) plus statin on the progression of atherosclerosis. methods: patients receiving statin therapy for dyslipidemia and with coronary artery disease (cad) were assigned randomly in an open-label manner to the epa (1,800 mg/day) -plus-statin group (n= 25; combined-therapy group) or to the statin-only group (n= 25),and followed for 48 weeks. at baseline and 48 weeks after enrollment,oxidative stress,brachial-ankle pulse wave velocity (bapwv) and stiffness parameter β-index of the carotid were measured. results: the lipid profile remained unchanged throughout the study. although the median value of bapwv increased more in the statin-only group than in the combined-therapy group,this difference was not significant (p= 0.29); however,a decrease in bapwv was associated with combined-therapy treatment by multiple regression analysis adjusted for age and mean blood pressure (p= 0.04). in addition,the β-index of the carotid was lower in the combined-therapy group than in the statin-only group (p= 0.02). furthermore,although the difference in the reduction of the urinary concentration of 8-isoprostane between the two groups did not reach statistical significance,this concentration was significantly lower in the combined-therapy group with higher baseline levels (≥ 183 pg/ml · cr) of urinary 8-isoprostane (p= 0.004).conclusions: epa may reduce oxidative stress and inhibit the progression of arterial stiffness more efficiently than statin-only therapy in patients with dyslipidemia and cad.