One-year atorvastatin treatment in hypercholesterolemic patients with or without carotid artery disease

• Published in: International angiology Vol. 25; no. 1; pp. 26 - 34
• Main Authors: AVELLONE, G, DI GARBO, V, ABRUZZESE, G, CAMPISI, D, DE SIMONE, R, RANELI, G, LICATA, G
• Format: Journal Article
• Language: English
• Published: Torino Minerva Medica 01.03.2006; Edizioni Minerva Medica
• Subjects: Anticholesteremic Agents - therapeutic use; Apolipoprotein A-I - blood; Apolipoprotein A-I - drug effects; Apolipoproteins B - blood; Apolipoproteins B - drug effects; Atherosclerosis (general aspects, experimental research); Atorvastatin Calcium; Biological and medical sciences; Blood and lymphatic vessels; Blood Platelets - drug effects; C-Reactive Protein - drug effects; C-Reactive Protein - metabolism; Cardiology. Vascular system; Carotid Artery Diseases - blood; Carotid Artery Diseases - drug therapy; Carotid Artery, Common - pathology; Cholesterol, HDL - blood; Cholesterol, HDL - drug effects; Cholesterol, LDL - blood; Cholesterol, LDL - drug effects; Diseases of the cardiovascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fibrinogen - drug effects; Fibrinogen - metabolism; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipoproteinemia Type II - blood; Hyperlipoproteinemia Type II - drug therapy; Male; Medical sciences; Middle Aged; Patient Compliance; Pyrroles - therapeutic use; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Time Factors; Treatment Outcome; Triglycerides - blood; Cardiovascular disease; Lipids; Hyperlipoproteinemia; Lipoprotein; Blood vessel; Fibrinogen; Carotid artery; Dyslipemia; hs-CRP; Human; Enzyme; Enzyme inhibitor; Metabolic diseases; Statin derivative; Heterozygous familial hypercholesterolemia; Artery; Cholesterol; Hypercholesterolemia; Treatment; Carotid; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; Circulatory system; Oxidoreductases; Antilipemic agent
• ISSN: 0392-9590; 1827-1839

Statins are the drugs of choice in heterozygous familial hypercholesterolemia (FH), which has a high risk of premature cardiovascular events including myocardial infarction, stroke, and surgical revascularization. A 1-year open-label study was conducted to test the efficacy and tolerability of Atorvastatin titrated to the target, in proven FH patients and to evaluate certain inflammatory parameters. One hundred and two FH patients (44 men and 58 women; mean age 58.7+/-3.6 years) were included in the study. After evaluation using the B-mode duplex scanning system of extracranial carotid arteries, the patients were divided into two groups: Group 1 (15 men, 25 women) with carotid plaques or intima-media thickness (IMT) greater than 0.95 mm and Group 2 (30 men, 32 women) without carotid plaques or IMT less than 0.95 mm. After a 6-week hypolipemic diet phase all the patients were treated with atorvastatin titrated to achieve a low density lipoprotein (LDL-C) <100 mg/dL. Patients with carotid lesions were also submitted to an oral fixed dose of aspirin 100 mg/day. In patients without and with carotid lesions, atorvastatin treatment (mean dosage: 23.5 mg/day) reduced triglycerides by 8.7% (P<0.005) and 10.6% (P<0.005), total cholesterol by 41.5% (P<0.005) and 42.6% (P<0.005), LDL-C by 55.8% (P<0.005) and 57.3% (P<0.005) and apolipoprotein B by 38.3% (P<0.005) and 37.2% (P<0.005) respectively, and increased the mean levels of high density lipoprotein cholesterol (HDL-C) by 8.7% (P<0.005) and 11% (P<0.005), and apolipoprotein A-I by 3.2% (P<0.05) and 3.3%, respectively. In both groups of patients the mean decrease (52 weeks) of fibrinogen was 19.8% (P<0.005) and 10.4% (P<0.005), respectively and of high sensitivity C-reactive protein (hs-CRP), 36.2% (P<0.005) and 38.2% (P<0.005), respectively. No variation of the parameters of safety and clinical tolerability of the drugs administered was observed. No variation in hematocrit in the patients taking ASA treatment was observed. In FH patients, 1-year atorvastatin treatment titrated to the target (LDL-C <100 mg/dL) was well tolerated and improved serum lipid levels and inflammatory parameters.