The MIAMI Study (Markers of inflammation and Atorvastatin effect in previous myocardial infarction) : results of a prospective, multicenter study

Objective: MIAMI is a prospective multicenter clinical study designed to investigate the relationship between C-IMT progression and changes in circulating markers of inflammation, coagulation and endothelial dysfunction in patients with stable CAD treated for two years with 20 mg/day atorvastatin. Methods: C-IMT, blood lipids and soluble markers were measured at baseline, at the 12th month and at the end of the study in eighty-five patients. Results: Atorvastatin induced C-IMT regression. Fibrinogen, TFPI-total, sICAM-1, sE-selectin, IL-8 and vWF, but not hs-CRP, IL-18, TFPI-free, sVCAM-1, IL-6, TNF-α and sCD40L, decreased upon treatment. Changes in lipids did not correlate with C-IMT regression. Changes in single soluble markers correlated poorly with C-IMT regression, but strongly when combined in relevant composite scores (inflammation/coagulation-score, endothelial activation-score, soluble markers-score and total-score). Conclusions: In patients with stable CAD, a moderate dose of atorvastatin was associated with regression of C-IMT. This effect was correlated with changes of inflammation, thrombosis and endothelial dysfunction profiles. Funding: Partial support by a grant from Pfizer- Italia