In patients with moderate, dietary noncorrigible
hyperlipoproteinemia type IIb and
ischemic heart disease, treatment with
nicotinic acid is limited by the side effects of the
drug. In 100 patients, 6-month treatment with
nicotinic acid (n = 50) or "
essential" phospholipids (EPL);
Lipostabil, manufacturer: Rhône-Poulenc Rorer) (n = 50) indicated comparable efficacy for both substances: Significant (p < .001) reductions of serum total
cholesterol,
low-density lipoprotein (
LDL) cholesterol, and
triglyceride values were similar in both groups, while
nicotinic acid increased
high-density lipoprotein (
HDL) cholesterol significantly (p < .01) better than
Lipostabil. A detailed analysis of ultracentrifugal
lipoprotein profiles,
hydroperoxide concentrations in
LDL, and
cholesterol-accepting properties of HDL in a small number of
Lipostabil- and
nicotinic acid-treated patients revealed favorable shifts in the
lipoprotein profile, significant (p < .05) reductions of
LDL hydroperoxides, and favorable increases of the most antiatherogenic HDL2b subfraction only in the
Lipostabil-treated group. Clinically, both medications reduced the intensity and number of
angina pectoris attacks per week (p < .05), but only
Lipostabil-treated patients significantly (p < .05) increased their working capacity in the veloergometric test. Since in the
nicotinic acid-treated group dropouts (nine patients, eight related to the
drug) and side effects [14] exceeded those in the
Lipostabil-treated group (two dropouts not related to the
drug, no side effects), it is suggested that
Lipostabil is a preferable alternative in the treatment of patients with moderate, dietary noncorrigible
hyperlipoproteinemia IIb and
ischemic heart disease.