The efficacy of
simvastatin in reducing plasma
cholesterol is well documented. Other molecules within the apo
lipoprotein family, particularly
lipoprotein (a) Lp(a), have recently been found to have a predictive and/or causative role in
atherosclerosis. Based on these considerations, we studied 15 patients affected by primary
hypercholesterolemia to evaluate the effect of
simvastatin in Lp(a) and
apoprotein plasma levels (A1, B, C2, C3, E), in addition to the classic
lipid parameters. Clinical and laboratory parameters were evaluated before
therapy, after 12 weeks of
therapy, and after 5 weeks of
drug withdrawal.
Simvastatin therapy produced a significant reduction in total
cholesterol (CH) and
LDL-CH (p < 0.0001), and a significant increase in HDL-CH (p < 0.01); no variation was observed in
triglyceride (TG) levels.
Simvastatin therapy further showed a significant decrease in
apoC2 (p < 0.05), the apo C2/C3 ratio (p < 0.01), and
apoE (p < 0.01), as well as a significant increase in Lp(a) plasma levels (p < 0.05). All of the parameters studied returned to pretreatment values 5 weeks after
drug withdrawal; only HDL-CH persisted above the values reached during
therapy. Our data agree with those documenting the beneficial effect of
simvastatin in greatly decreasing CH and
LDL-CH, but point out the need for further studies on the long-term effect of
simvastatin on
apoprotein molecules, such as on Lp(a), in order to fully establish its role in the
secondary prevention of
atherosclerosis.