Document Detail


Beneficial effects of atorvastatin on sd LDL and LDL phenotype B in statin-naive patients and patients previously treated with simvastatin or pravastatin.
MedLine Citation:
PMID:  16186066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The presence of increased levels of small dense (sd) LDL (phenotype B) is associated with a substantial increase of cardiovascular disease risk. Since lowering of plasma low-density lipoprotein-cholesterol (LDL-C) by statins involves an up-regulation of the LDL receptor, we questioned whether LDL lowering by atorvastatin affects different LDL subfractions equally. METHODS: Fifty-four hypercholesterolemic patients, requiring treatment for prevention of coronary heart disease received atorvastatin (10, 20 or 40 mg/day), either as initial therapy (n=33), or as replacement therapy (n=21) for pravastatin or simvastatin (both at 40 mg/day). In addition to plasma lipid measurements, cholesterol LDL subfractions were separated and analysed before and after 3 months of treatment. RESULTS: In addition to the expected LDL-C decrease (-34%; p<0.0001), a major reduction in sd LDL occurred after atorvastatin therapy (-38.2%; p<0.0001). Interestingly, sd LDL decreased as much in patients previously treated with other statins (-36%; p<0.002). A close correlation (r=0.89, p<0.001) was found between reduction of sd LDL and that of LDL-C, in patients with phenotype B. Although high-density lipoprotein-cholesterol (HDL-C) was not affected by atorvastatin treatment, plasma triglycerides decreased by 27.4% (p<0.0001). Only a weak correlation (r=0.35, p<0.01) was found between the reduction of plasma triglycerides and the decrease of sd LDL after atorvastatin treatment. CONCLUSION: These results show that the reduction of LDL-C by atorvastatin largely reflects a lowering of sd LDL. Our data also suggest that triglyceride lowering plays only a partial role in sd LDL reduction.
Authors:
S Baldassarre; O Scruel; R J Deckelbaum; I E Dupont; J Ducobu; Y A Carpentier
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  104     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-27     Completed Date:  2006-02-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  338-45     Citation Subset:  IM    
Affiliation:
L. Deloyers Laboratory for Experimental Surgery and Cardiovascular Center, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anticholesteremic Agents / therapeutic use*
Cholesterol, LDL / blood
Coronary Disease / blood,  prevention & control
Female
Heptanoic Acids / therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Hypercholesterolemia / blood,  drug therapy*
Lipoproteins, LDL / blood,  classification
Male
Middle Aged
Pravastatin / therapeutic use
Prospective Studies
Pyrroles / therapeutic use
Simvastatin / therapeutic use
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, LDL; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Lipoproteins, LDL; 0/Pyrroles; 0/Triglycerides; 110862-48-1/atorvastatin; 79902-63-9/Simvastatin; 81093-37-0/Pravastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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