Effects of atorvastatin on Lp(a) and lipoprotein profiles in hemodialysis patients
| Autor: | Cynthia J. Denu-Ciocca, Kimberly A Dornbrook-Lavender, Hyunsook Chin, Melanie S. Joy, Susan L. Hogan |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Apolipoprotein B Atorvastatin medicine.medical_treatment Lipoproteins Hypercholesterolemia 030204 cardiovascular system & hematology Fibrinogen 030226 pharmacology & pharmacy Gastroenterology 03 medical and health sciences 0302 clinical medicine Renal Dialysis Internal medicine medicine Humans Pharmacology (medical) Pyrroles Serum Albumin Aged Apolipoproteins B biology Apolipoprotein A-I Dose-Response Relationship Drug business.industry Anticholesteremic Agents Lipoprotein(a) Cholesterol LDL Middle Aged Hydroxymethylglutaryl-CoA reductase Endocrinology C-Reactive Protein Cholesterol Heptanoic Acids HMG-CoA reductase biology.protein lipids (amino acids peptides and proteins) Female Hemodialysis business Lipoprotein medicine.drug |
| Zdroj: | The Annals of pharmacotherapy. 42(1) |
| ISSN: | 1542-6270 |
| Popis: | Background: Dialysis patients have many underlying traditional and nontraditional risk factors that may predispose them to a high prevalence of cardiovascular disease. The effects of statins (eg, atorvastatin) on altering nontraditional lipoprotein measures in dialysis patients have not been extensively investigated. Objective: To evaluate the efficacy of atorvastatin compared with a control group in inducing changes in lipoprotein(a) [Lp(a)], apolipoprotein (Apo) A-1, Apo-B, and fibrinogen levels, as well as the conventional lipoprotein profile, in hemodialysis patients over 36 weeks; secondary objectives were to assess changes in C-reactive protein, albumin, and safety measures. Methods: Forty-five hemodialysis patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 100 mg/dL were randomized to parallel groups: atorvastatin (n = 19) or no treatment (n = 26). The atorvastatin dose was titrated from 10 mg to achieve an LDL-C goal of 100 mg/dL or less and therapy was continued for 36 weeks. Biochemical and lipoprotein laboratory tests for efficacy outcomes were obtained at baseline, 12 weeks, and 36 weeks. Results: The atorvastatin group exhibited clinically significant reductions (mean ± SD) compared with controls in total cholesterol (–21.7 ± 41.7 vs –3.2 ± 40.0 mg/dL, respectively; p = 0.017) and LDL-C (–13.1 ± 32.0 vs –1.1 ± 38.4 mg/dL. respectively; p = 0.056) levels, as well as Lp(a) (–10.6 ± 27 vs 3.5 ± 17.8 mg/dL, respectively; p = 0.046). Statistical analyses included analysis of variance on ranked measures for multivariable modeling and paired t-test to determine changes in efficacy measures between baseline and 36 weeks within groups. Conclusions: Atorvastatin was safe and effective in reducing Lp(a), total cholesterol, and LDL-C levels. Given the prevalence of atherosclerosis in hemodialysis patients, therapy aimed at reducing traditional and nontraditional risk factors may be beneficial. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|