Cholesterol levels after 3 days of high-dose simvastatin in patients at moderate to high risk for coronary events

Michelena, Héctor I.; Osorio, Luis A.; Citkowitz, Elena

doi:10.1016/j.ijcard.2004.08.021

Cited by 5 publications

(3 citation statements)

References 29 publications

(27 reference statements)

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“…Present results are in cagreement with our previous study showing rapid reduction of TC and LDL-C after administration of fluvastatin 80 mg in ACS patients [6]. A decrease of TC and LDL-C has been reported also by Michelena et al [14] after three days of high-dose simvastatin therapy in stable high-risk patients, by Zhou et al [15] after one-week atorvastatin therapy of ACS patients, by Marchesi et al [16] after one-week atorvastatin therapy in women with hypercholesterolemia, and by Li et al [17] after two weeks of simvastatin treatment in patients with dyslipidemia. On the other hand, Tsunekawa et al [18] did not observe any difference in blood lipids after a three-day therapy with cerivastatin in elderly diabetic patients; this discrepancy can be at least partly explained by the low dose of cerivastatin (0.15 mg/day) as well as by different patient's characteristics.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, we have determined the lipid profile in non-fasting patients in the baseline and then in fasting conditions in D1 and D2. Non-fasting lipid measurements were, however, used also in other studies focusing on the rapid effect of statins [6,12,14] and we did not observe TG levels high enough to interfere with the analysis of other lipid parameters; moreover, surprisingly, we have found that after administration of atorvastatin the fasting TG levels were higher than the non-fasting baseline value.…”

Section: Discussionsupporting

confidence: 44%

“…In other studies focusing on the short-term effect of statins on the lipid profile that were carried out with stable patients and on lipid levels measured after three to fourteen days of therapy HDL-C and TG were not significantly changed [14-17]. We have no clear explanation for the marked increase in TG levels in our study, despite the fact that the baseline sample was mostly taken in non-fasting conditions whereas the D1 and D2 samples were fasting.…”

Section: Discussionmentioning

confidence: 99%

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Immediate effect of intensive atorvastatin therapy on lipid parameters in patients with acute coronary syndrome

2010

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BackgroundIntensive statin therapy decreases mortality and incidence of coronary events in patients after acute coronary syndrome (ACS). Recently it has been reported that spontaneous lipid levels remain clinically stable during ACS. The immediate influence of lipid levels by high-dose statin therapy initiated at admission in ACS patients is, however, not clear.MethodsWe have analyzed a group of 114 patients with ACS (mean age 63.7; females 25.4%). Atorvastatin 80 mg was administered at admission and then once daily for the rest of hospitalization. The levels of total cholesterol (TC), LDL-cholesterol (LDL), HDL-cholesterol (HDL), and triglycerides (TG) were measured at admission (D0), and then every morning of hospitalization (D1, D2).ResultsThe mean entry values (D0) of TC, LDL, HDL and TG (in mmol/L) were 5.24, 3.26, 1.07 and 1.31, respectively. The therapy with atorvastatin 80 mg resulted in a decrease of TC levels in the first morning (D1) by 6.1% and in the second morning (D2) by 13.2% (p < 0.001 for all comparisons with the entry value D0); LDL was decreased by 5.8% (D1) and 15.6% (D2) (p < 0.001 vs. D0); the level of HDL was decreased by 7.5% (D1) and 12.1% (D2) (p < 0.001 vs. D0). In contrast, the TG level was higher in the first morning (D1) by 20.6% and in the following morning (D2) by 25.5% (p < 0.05 vs. D0).ConclusionsWe have shown that intensive statin therapy started at admission in ACS patients has a highly significant, immediate effect on all monitored lipid levels. Since TC and LDL levels were decreased as predicted, reduction in HDL and increase in TG levels suggest a different acute effect of high-dose statin on lipid levels in comparison with long-term treatment of ACS patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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Immediate effect of intensive atorvastatin therapy on lipid parameters in patients with acute coronary syndrome

2010

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Immediate effect of fluvastatin on lipid levels in acute coronary syndrome

et al. 2007

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It is widely assumed that acute benefit of statin therapy is mediated especially by non-lipid effects. The immediate influence of statins on lipid levels in patients with acute coronary syndrome (ACS) is, however, not clear. A total of 64 consecutive patients with ACS were randomized at admission to fluvastatin 80 mg (Group 1, N = 32) or standard therapy without statin (Group 2, N = 32). The levels of total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), and triglycerides (TG) were examined at admission and after 24 h. Baseline characteristics were comparable in both groups. In Group 1, fluvastatin significantly decreased the levels of TC by 14.5%, LDL-C by 17.2%, and HDL-C by 10.0% (P < 0.001); TG were not influenced. In Group 2 only marginal reductions in TC (by 4.1%, P = 0.03) and HDL-C (by 7.5%, P < 0.01) were detected; the levels of LDL-C and TG were not changed. As compared with Group 2, in Group 1 the final levels of TC (P = 0.02) and LDL-C (P = 0.01) were significantly lower. Fluvastatin therapy, when started at admission in patients with ACS, significantly reduces TC and LDL-C already after 24 h. We suggest that the lipid-lowering effect of statins in the therapy of ACS is probably as prompt as non-lipid effects.

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