Effect of statins on LDL particle size in patients with familial combined hyperlipidemia: a comparison between atorvastatin and pravastatin

详细信息    查看全文

• 作者：Cesare R. Sirtori ; Laura Calabresi ; Livia Pisciotta ; Luigi Cattin ; Paolo Pauciullo ; Mario Montagnani ; Enzo Manzato ; Gabriele Bittolo Bon ; Renato Fellin
• 关键词：Familial combined hyperlipidemia ; Small dense LDL ; Statins
• 刊名：Nutrition, Metabolism and Cardiovascular Diseases
• 出版年：2005
• 出版时间：February 2005
• 年：2005
• 卷：15
• 期：1
• 页码：47-55
• 全文大小：145 K

文摘

Elevation of plasma cholesterol and/or triglycerides, and the prevalence of small dense low density lipoproteins (LDL) particles remarkably increase the risk in patients with familial combined hyperlipidemia (FCHL). There are, at present, inconsistent data on the effects of different treatments on size and density of LDL particles in FCHL patients.

Methods and results

A multicenter, randomized, double-blind, double-dummy, parallel group study was designed to evaluate the effect of 3 months' treatment with atorvastatin (10 mg/day) or pravastatin (20 mg/day) on the lipid/lipoprotein profile and LDL size in a total of 86 FCHL patients. Both statins significantly lowered plasma total and LDL cholesterol, with a significantly higher hypocholesterolemic effect observed with atorvastatin (−26.8 ± 11.1 % and −35.9 ± 11.1 % , respectively) compared to pravastatin (−17.6 ± 11.1 % and −24.5 ± 10.2 % ). The percent decrease in plasma triglycerides was highly variable, but more pronounced with atorvastatin (−19.8 ± 29.2 % ) than with pravastatin (−5.3 ± 48.6 % ). Opposite changes in LDL size were seen with the 2 treatments, with increased mean LDL particle diameter with atorvastatin, and decreased diameter with pravastatin, and significant between treatment difference in terms of percent modification vs baseline (+0.5 ± 1.6 % with atorvastatin vs −0.3 ± 1.8 % with pravastatin).

Conclusions

The present results support the evidence indicative of a greater hypocholesterolemic effect of atorvastatin compared to pravastatin, and in addition show a raising effect of atorvastatin on the size of LDL particles in FCHL patients.