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

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.
A multicenter, randomized, double-blind, double-dummy, parallel group study was designed to evaluate the effect of 3 months' treatment with atorvastatin (10mg/day) or pravastatin (20mg/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).
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.
AuthorsCesare R Sirtori, Laura Calabresi, Livia Pisciotta, Luigi Cattin, Paolo Pauciullo, Mario Montagnani, Enzo Manzato, Gabriele Bittolo Bon, Renato Fellin
JournalNutrition, metabolism, and cardiovascular diseases : NMCD (Nutr Metab Cardiovasc Dis) Vol. 15 Issue 1 Pg. 47-55 (Feb 2005) ISSN: 0939-4753 [Print] Germany
PMID15871851 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Heptanoic Acids
  • Pyrroles
  • Triglycerides
  • Atorvastatin Calcium
  • Pravastatin
  • Anticholesteremic Agents (therapeutic use)
  • Atorvastatin Calcium
  • Cholesterol, LDL (blood, drug effects)
  • Double-Blind Method
  • Female
  • Heptanoic Acids (therapeutic use)
  • Humans
  • Hyperlipidemia, Familial Combined (drug therapy)
  • Male
  • Middle Aged
  • Particle Size
  • Pravastatin (therapeutic use)
  • Pyrroles (therapeutic use)
  • Treatment Outcome
  • Triglycerides (blood)

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