Use of niacin, statins, and resins in patients with combined hyperlipidemia.

Abstract

Patients in the original Familial Atherosclerosis Treatment Study (FATS) cohort were subgrouped into those with triglyceride levels < or = 120 mg/dL (n = 26) and those with triglyceride levels > or = 190 mg/dL (n = 40). Their therapeutic responses to niacin plus colestipol, lovastatin plus colestipol, colestipol alone, or placebo were determined. Therapeutic response was also determined in the same 2 triglyceride subgroups (n = 12 and n = 27, respectively) of patients selected for low levels of high-density lipoprotein (HDL) cholesterol and coronary artery disease. These triglyceride criteria were chosen to identify patient subgroups with high likelihood of "pattern A" (normal-size low-density lipoprotein [LDL] particles and triglyceride < or = 120 mg/dL) or "pattern B" (small dense LDL and triglyceride > or = 190 mg/dL). Our findings in these small patient subgroups are consistent with the emerging understanding that coronary artery disease patients presenting with high triglyceride levels have lower HDL-C, smaller less buoyant LDL-C, and greater very low-density lipoprotein (VLDL) cholesterol and VLDL apolipoprotein B, and are more responsive to therapy as assessed by an increase in HDL-C and reduction in triglycerides, VLDL-C, and VLDL apolipoprotein B. In the FATS high-triglyceride subgroup with these characteristics, a tendency toward greater therapeutic improvement in coronary stenosis severity was observed among those treated with either of the 2 forms of intensive cholesterol-lowering therapy. This improvement is associated with therapeutic reduction of LDL-C and elevation of HDL-C, but also appears to be associated with drug-induced improvement in LDL buoyancy.

• Authors: B G Brown, A Zambon, D Poulin, A Rocha, V M Maher, J W Davis, J J Albers, J D Brunzell
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 81 Issue 4A Pg. 52B-59B (Feb 26 1998) ISSN: 0002-9149 [Print] United States
• PMID: 9526815 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Review)

Chemical References

• Anticholesteremic Agents
• Apolipoproteins
• Cholesterol, HDL
• Cholesterol, LDL
• Hypolipidemic Agents
• Triglycerides
• Niacin
• Lovastatin
• Colestipol

Topics

• Anticholesteremic Agents (administration & dosage)
• Apolipoproteins (blood)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Clinical Trials as Topic
• Cohort Studies
• Colestipol (administration & dosage)
• Coronary Disease (etiology)
• Drug Therapy, Combination
• Humans
• Hyperlipidemia, Familial Combined (blood, drug therapy)
• Hypolipidemic Agents (administration & dosage)
• Lovastatin (administration & dosage)
• Niacin (administration & dosage)
• Risk Factors
• Triglycerides (blood)