Document Detail


Effects of atorvastatin on fasting and postprandial lipoprotein subclasses in coronary heart disease patients versus control subjects.
MedLine Citation:
PMID:  12356379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of atorvastatin at 20, 40, and 80 mg/day on plasma lipoprotein subclasses were examined in a randomized, placebo-controlled fashion over 24 weeks in 103 patients in the fasting state who had coronary heart disease (CHD) with low-density lipoprotein (LDL) cholesterol levels >130 mg/dl. The effects of placebo and atorvastatin 40 mg/day were examined in 88 subjects with CHD in the fasting state and 4 hours after a meal rich in saturated fat and cholesterol. These findings were compared with results in 88 age- and gender-matched control subjects. Treatment at the 20, 40, and 80 mg/day dose levels resulted in LDL cholesterol reductions of 38%, 46%, and 52% (all p <0.0001), triglyceride reductions of 22%, 26%, and 30% (all p <0.0001), and high-density lipoprotein (HDL) cholesterol increases of 6%, 5%, and 3%, respectively (all p <0.05 at the 20- and 40-mg doses). The lowest total cholesterol/HDL cholesterol ratio was observed with the 80 mg/day dose of atorvastatin (p <0.0001 vs placebo). Remnant-like particle (RLP) cholesterol decreased 33%, 34%, and 32%, respectively (all p <0.0001). Lipoprotein(a) [Lp(a)] cholesterol decreased 9%, 16%, and 21% (all p <0.0001), although Lp(a) mass increased 9%, 8%, and 10%, respectively (all p <0.01). In the fed state, atorvastatin 40 mg/day normalized direct LDL cholesterol (29% below controls), triglycerides (8% above controls), and RLP cholesterol (10% below controls), with similar reductions in the fasting state. At this same dose level, atorvastatin treatment resulted in 39%, 35%, and 59% decreases in fasting triglyceride in large, medium, and small very LDLs, as well as 45%, 33%, and 47% reductions in cholesterol in large, medium, and small LDL, respectively, as assessed by nuclear magnetic resonance (all significant, p <0.05), normalizing these particles versus controls (77 cases vs 77 controls). Moreover, cholesterol in large HDL was increased 37% (p <0.001) by this treatment. Our data indicate that atorvastatin treatment normalizes levels of all classes of triglyceride-rich lipoproteins and LDL in both the fasting and fed states in patients with CHD compared with control subjects.
Authors:
Ernst J Schaefer; Judith R McNamara; Timothy Tayler; Jennifer A Daly; Joi A Gleason; Leo J Seman; Andrea Ferrari; Joel J Rubenstein
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  90     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-01     Completed Date:  2002-10-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  689-96     Citation Subset:  AIM; IM    
Affiliation:
Atherosclerosis Research Laboratory, Lipid and Heart Disease Prevention Clinic, Department of Medicine, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA. eschaefer@hnrc.tufts.edu
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MeSH Terms
Descriptor/Qualifier:
Anticholesteremic Agents / administration & dosage,  pharmacology*,  therapeutic use
Cholesterol / blood
Cholesterol, HDL / blood,  drug effects
Cholesterol, LDL / blood,  drug effects
Coronary Disease / blood,  prevention & control*
Dietary Fats / metabolism*
Dose-Response Relationship, Drug
Fasting / blood*
Female
Heptanoic Acids / administration & dosage,  pharmacology*,  therapeutic use
Humans
Lipoprotein(a) / blood,  drug effects
Lipoproteins / blood,  classification,  drug effects*
Male
Middle Aged
Postprandial Period*
Pyrroles / administration & dosage,  pharmacology*,  therapeutic use
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Dietary Fats; 0/Heptanoic Acids; 0/Lipoprotein(a); 0/Lipoproteins; 0/Pyrroles; 0/Triglycerides; 110862-48-1/atorvastatin; 57-88-5/Cholesterol

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


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