Effects of Rosuvastatin Versus Atorvastatin, Alone or in Combination, on Lipoprotein (a): A Single-Center Study
Journal
Annals of Pharmacotherapy
Date Issued
2016
Author(s)
Daka, Arlinda
Domazetovska, Saska
DOI
DOI: 10.1177/1060028016652415
Abstract
Background: There are little evidences about the therapeutic efficacy of different lipid-lowering agents in the reduction
of elevated lipoprotein(a) [Lp(a)]. Objective: testing the effect of different lipid-lowering agents on elevated Lp(a).
Methods: prospective interventional study performed in patients with CAD, or high CAD risk, with Lp(a), >50 mg/dL.
Lp(a), total cholesterol (C), HDL-C, LDL-C, triglycerides (TGs), apolipoprotein (Apo) A1, Apo B, enzymes of myocyte
and hepatic injury were comparatively analyzed between 4 lipid-lowering strategies: rosuvastatin (R group) 40 mg,
atorvastatin (A group) 80 mg, atorvastatin 40 mg add-on micronized fenofibrate (A+F group), and atorvastatin 40 mg
add-on 1 g extended-release niacin (A+ERN group). Comparison was made for their therapeutic efficacy on Lp(a), and
safety. Results: 87 patients with mean Lp(a) 94.6 ± 39.6 mg/dL were analyzed. Groups: 25 patients in the R, 22 in the
A, 20 in the A+F and 20 in A+ERN group. Significant reduction in all lipid fractions in all treatment groups was reported
after 6 months. The average reduction of Lp(a) was 15.9 ± 21.0 mg/dL, with: 18.2 ± 24.8 (P = 0.001) in the R group, 17.3
± 10.4 (P = 0.001) in A+F, 19.5 ± 10.9 (P = 0.001) in A+ERN and the lowest in the A group (11.24 ± 22.91, P = 0.032).
No adverse effects were observed in any of the treatment groups. Conclusions: When compared with atorvastatin, it
seems that rosuvastatin can achieve more significant decrease of Lp(a).The efficacy of the second one can be increased
by adding fibrate or ERN.
of elevated lipoprotein(a) [Lp(a)]. Objective: testing the effect of different lipid-lowering agents on elevated Lp(a).
Methods: prospective interventional study performed in patients with CAD, or high CAD risk, with Lp(a), >50 mg/dL.
Lp(a), total cholesterol (C), HDL-C, LDL-C, triglycerides (TGs), apolipoprotein (Apo) A1, Apo B, enzymes of myocyte
and hepatic injury were comparatively analyzed between 4 lipid-lowering strategies: rosuvastatin (R group) 40 mg,
atorvastatin (A group) 80 mg, atorvastatin 40 mg add-on micronized fenofibrate (A+F group), and atorvastatin 40 mg
add-on 1 g extended-release niacin (A+ERN group). Comparison was made for their therapeutic efficacy on Lp(a), and
safety. Results: 87 patients with mean Lp(a) 94.6 ± 39.6 mg/dL were analyzed. Groups: 25 patients in the R, 22 in the
A, 20 in the A+F and 20 in A+ERN group. Significant reduction in all lipid fractions in all treatment groups was reported
after 6 months. The average reduction of Lp(a) was 15.9 ± 21.0 mg/dL, with: 18.2 ± 24.8 (P = 0.001) in the R group, 17.3
± 10.4 (P = 0.001) in A+F, 19.5 ± 10.9 (P = 0.001) in A+ERN and the lowest in the A group (11.24 ± 22.91, P = 0.032).
No adverse effects were observed in any of the treatment groups. Conclusions: When compared with atorvastatin, it
seems that rosuvastatin can achieve more significant decrease of Lp(a).The efficacy of the second one can be increased
by adding fibrate or ERN.
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