Use of Niacin, Statins, and Resins in Patients With Combined Hyperlipidemia

Autor: John D. Brunzell, Alberto Zambon, B. Greg Brown, Drew Poulin, Anita Rocha, John J. Albers, Joseph Davis, Vincent Maher
Rok vydání: 1998
Předmět:
Zdroj: The American Journal of Cardiology. 81:52B-59B
ISSN: 0002-9149
Popis: Patients in the original Familial Atherosclerosis Treatment Study (FATS) cohort were subgrouped into those with triglyceride levels ≤120 mg/dL (n = 26) and those with triglyceride levels ≥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 ≤120 mg/dL) or “pattern B” (small dense LDL and triglyceride ≥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.
Databáze: OpenAIRE
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