Effects of simvastatin and ciprofibrate alone and in combination on lipid profile, plasma fibrinogen and low density lipoprotein particle structure and distribution in patients with familial combined hyperlipidaemia and coronary artery disease

Autor: Melachrini C. Mayroudi, Athanasios G. Kontopoulos, Vasilios G. Athyros, Harisios Boudoulas, Athanasios A. Papageorgiou, Haris A. Hatzikonstandinou
Rok vydání: 1996
Předmět:
Adult
Male
Simvastatin
medicine.medical_specialty
Very low-density lipoprotein
Hyperlipidemia
Familial Combined
Coronary Disease
Clofibric Acid
chemistry.chemical_compound
High-density lipoprotein
Double-Blind Method
Internal medicine
medicine
Humans
Lovastatin
Prospective Studies
Hypolipidemic Agents
Intermediate-density lipoprotein
Analysis of Variance
Cholesterol
business.industry
Fibric Acids
Fibrinogen
General Medicine
Middle Aged
Lipids
Lipoproteins
LDL
Survival Rate
Treatment Outcome
Endocrinology
chemistry
Low-density lipoprotein
Drug Therapy
Combination
Female
lipids (amino acids
peptides
and proteins)
Density gradient ultracentrifugation
Ciprofibrate
Morbidity
Safety
Cardiology and Cardiovascular Medicine
business
Low-density lipoprotein particle
Ultracentrifugation
Follow-Up Studies
medicine.drug
Zdroj: Coronary Artery Disease. 7:843-850
ISSN: 0954-6928
DOI: 10.1097/00019501-199611000-00009
Popis: BACKGROUND Hypolipidaemic agents do not usually normalize all of the multiple lipoprotein abnormalities in patients with familial combined hyperlipidaemia (FCHL). The effect of the simvastatin-ciprofibrate combination in comparison with each drug alone on the lipoprotein abnormality patterns was studied in patients with FCHL and coronary artery disease (CAD). METHODS Sixty patients (53 men and seven women), mean age 52 years (range 36-60 years), were studied. After a 4-week placebo period, patients were randomly assigned to three groups. The first group (n = 20) received simvastatin (20 mg daily), the second group (n = 20) ciprofibrate (100 mg daily) and the third group (n = 20) the combination of both drugs for a 12-week period. Parameters measured were as follows: plasma fibrinogen, total cholesterol, triglycerides, low density lipoprotein (LDL), very low density lipoprotein, intermediate density lipoprotein, and high density lipoprotein cholesterol, as well as LDL subfraction distribution and structure by density gradient ultracentrifugation. Apoproteins (apo) B and AI were assessed by immunoturbidometry. RESULTS At baseline, apoB, LDL cholesterol and triglycerides were increased, whereas LDL particles were small and dense. ApoB was significantly reduced by all three interventions. Drug combination and ciprofibrate significantly reduced plasma fibrinogen (-24 and -25%, respectively; P < 0.001) and triglycerides (-51 and -49%, respectively; P < 0.001). Drug combination and simvastatin significantly reduced LDL cholesterol (-25 and -22%, respectively; P < 0.001) compared with ciprofibrate (-10%; P < 0.01). Ciprofibrate and drug combination increased LDL particle size (parameter K -0.24 versus -0.61 and -0.30 versus -0.62, respectively; P < 0.001), whereas simvastatin had no significant effect on LDL particle size. The cholesterol content of LDL particles was reduced with ciprofibrate and the drug combination only in the dense LDL particles (LDL3-5) and increased in the light (LDL1-2) subfractions, whereas simvastatin reduced the cholesterol content of all LDL subfractions except LDL2. Ciprofibrate and drug combination reduced the triglyceride content of all LDL subfractions. CONCLUSION Combined treatment with simvastatin and ciprofibrate effectively reduced plasma fibrinogen, triglycerides, total and LDL cholesterol and increased LDL particle size in patients with FCHL and CAD. These effects might induce a clinical benefit for these patients.
Databáze: OpenAIRE
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