The effects of statins on HDL cholesterol in prevention of atherosclerosis (CROSBI ID 546287)
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Podaci o odgovornosti
Zaputović, Luka
engleski
The effects of statins on HDL cholesterol in prevention of atherosclerosis
Inverse relationship between HDL cholesterol and the risk for atherosclerotic cardiovascular disease has been found in many clinical trials. In the Helsinki Heart Study a 0.03 mmol/L increase in HDL resulted in about 2-3% coronary risk reduction. In the PROCAM study patients with total cholesterol 5.2-7.8 mmol/L had a 5 fold coronary risk increase if HDL levels were <0.9 mmol/L, and patients with HDL<0.9 mmol/L had a 3 fold coronary risk increase than those with HDL >0.9 mmol/L. In another post-PTCA trial the restenosis rate in patients with HDL>1.0 mmol/L was only 17%, while in those with HDL<1 mmol/L it was 64%. In the 4S study each 1% HDL increase achived with simvastatin resulted in a significant major cardiovascular events risk reduction of 0.8%. The results of VA-HIT trial showed that increasing HDL and lowering triglycerides in men with low baseline HDL and coronary artery disease, without reducing LDL, reduce coronary events. Because plasma levels of several lipoproteins correlate with the risk for atherosclerosis, not only LDL cholesterol is important. In the prevention of atherosclerosis some other lipidic and nonlipidic effects of hypolipemic drugs may be clinically relevant, especially their effects on HDL cholesterol, witch should also be a target for the treatment. In comparative studies simvastatin was more effective than pravastatin, lovastatin, fluvastatin and cerivastatin on LDL, triglycerides and HDL. Both simvastatin and atorvastatin substantially reduced LDL cholesterol. At usual doses, a similar proportion of patients achived LDL goal with both drugs. Nevertheless, simvastatin increased HDL cholesterol significantly more than atorvastatin, with lower incidence of side effects and smaller fibrinogen rise at the same time. The mechanisms for the different effects of simvastatin and atorvastatin on HDL cholesterol are not clearly established. Different effects of statins on plasma lipoprotein levels found in comparative studies may be clinically important in the prevention of atherosclerosis.
Atherosclerosis; HDL cholesterol; Statins
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Podaci o prilogu
27-27.
2001.
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objavljeno
Podaci o matičnoj publikaciji
Acta clinica Croatica
0353-9466
Podaci o skupu
9th Alpe Adria Cardiology Meeting
ostalo
06.06.2001-09.06.2001
Cavtat, Hrvatska