24256699
OBJECTIVE	Statins and calcium channel blockers have been proven beneficial toward improvement of endothelial function .
OBJECTIVE	The aim of this study was to compare the effect of combination therapy of statin and calcium channel blocker with solo treatment in patients with cardiac syndrome X.
RESULTS	Sixty-eight patients with cardiac syndrome X were divided randomly into three groups : fluvastatin ( 40 mg/day , n = 23 ) , diltiazem ( 90 mg/day , n = 22 ) , and combination of fluvastatin ( 40 mg/day ) and diltiazem ( 90 mg/day , n = 23 ) .
RESULTS	At the end of 90 days , the coronary flow reserve was improved in the three groups ( fluvastatin-treated group : 23.2 % ; diltiazem-treated group : 12.4 % ; fluvastatin + diltiazem-treated group : 29.1 % , all P < 0.05 ) .
RESULTS	The time to 1 mm ST segment depression increased significantly in the fluvastatin-treated group ( from 24197 to 410140 s , P < 0.05 ) , the diltiazem-treated group ( from 25891 to 392124 s , P < 0.05 ) , and the fluvastatin + diltiazem-treated group ( from 250104 to 446164 s , P < 0.05 ) .
RESULTS	The improvement in coronary flow reserve and prolonged time to 1 mm ST segment depression in the combination treatment group were more remarkable than in those who received monotherapy .
RESULTS	Combination therapy also induced a significant increase ( 35.6 % , P < 0.05 ) in nitric oxide and an apparent reduction ( 48.7 % , P < 0.05 ) in endothelin-1 .
CONCLUSIONS	Combination treatment with fluvastatin and diltiazem is more effective on endothelial function and exercise tolerance than solo treatment in patients with cardiac syndrome X.
CONCLUSIONS	The benefits of these drugs may be related to the elevation of nitric oxide and reduction of endothelin-1 .

