Effects of long-term treatment with simvastatin on plasma lipids and lipoproteins in patients with primary hypercholesterolemia

Thiery, Joachim; Creutzfeldt, C.; Creutzfeldt, W.; Walli, Autar K.; Seidel, D.

doi:10.1007/bf01796271

Cited by 11 publications

(3 citation statements)

References 45 publications

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“…In our study, we found a larger decrease (45%), even though many of the subjects (19 out of 46) were taking lower doses of simvastatin. The greater fall we observed is in line with recent studies [17,18], confirming that simvastatin appears to be one of the most potent of the HMG-CoA reductase inhibitors [27].…”

Section: Discussionsupporting

confidence: 81%

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Effect of simvastatin on high density lipoprotein subfractions and apolipoproteins in Type IIa hypercholesterolemia

Crook

Bruce

Worthington

et al. 1992

Cardiovasc Drug Ther

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Changes in plasma concentrations of high density lipoproteins (HDL) and triglycerides may partly explain the ability of cholesterol-lowering drugs to decrease the incidence of coronary heart disease. We measured the response of fasting plasma lipids, lipoproteins, and apolipoproteins in 46 subjects with Type IIa hypercholesterolemia treated with simvastatin for 3 months. The initial dose of simvastatin (10 mg/day) was subsequently increased up to 40 mg/day if the plasma cholesterol concentration had not fallen below 5.2 mmol/l. Plasma concentrations of HDL cholesterol and of the apolipoproteins AI and AII were increased by simvastatin. The increase in HDL cholesterol (9%) was due to increases in both subfractions (HDL2 17%; HDL3 7%), changes that would be consistent with a beneficial effect on cardiovascular risk. Simvastatin decreased plasma triglyceride concentrations by 25%. Plasma total cholesterol concentrations fell by 35% after 3 months of treatment; this fall was proportional to the initial concentration and was due almost entirely to a 45% fall in low density lipoprotein cholesterol. In contrast, plasma concentrations of lipoprotein Lp(a) were not affected by simvastatin.

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Section: Discussionsupporting

confidence: 81%

“…We have confirmed that simvastatin induces potentially beneficial changes not only in LDL but in triglycerides and HDL [17][18][19][20][21], ancilliary actions that may play an important role in the clinical effectiveness of this drug. We have also shown that the increase in HDL is due to increases in both HDL 2 and HDL 3.…”

Section: Discussionsupporting

confidence: 54%

Effect of simvastatin on high density lipoprotein subfractions and apolipoproteins in Type IIa hypercholesterolemia

Crook

Bruce

Worthington

et al. 1992

Cardiovasc Drug Ther

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“…During the testing period, numerous side effects like diarrhea, obstipation, other gastrointestinal diseases, myositis, rhabdomyolysis, and others were observed [112]. As a result of the clarification of the connection between hypercholesterolemia and coronary heart disease, numerous studies have been carried out in recent years with various medications [113–117]. With the introduction of selective and semiselective extracorporeal elimination methods for cholesterol, LDL, Lp(a), and triglycerides, all forms of previous therapy-resistant hypercholesterolemia can now be effectively treated [118].…”

Section: Ldl-apheresis Therapymentioning

confidence: 99%

LDL-Apheresis: Technical and Clinical Aspects

Bambauer¹,

Bambauer

Lehmann

et al. 2012

The Scientific World Journal

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The prognosis of patients suffering from severe hyperlipidemia, sometimes combined with elevated lipoprotein (a) levels, and coronary heart disease refractory to diet and lipid-lowering drugs is poor. For such patients, regular treatment with low-density lipoprotein (LDL) apheresis is the therapeutic option. Today, there are five different LDL-apheresis systems available: cascade filtration or lipid filtration, immunoadsorption, heparin-induced LDL precipitation, dextran sulfate LDL adsorption, and the LDL hemoperfusion. There is a strong correlation between hyperlipidemia and atherosclerosis. Besides the elimination of other risk factors, in severe hyperlipidemia therapeutic strategies should focus on a drastic reduction of serum lipoproteins. Despite maximum conventional therapy with a combination of different kinds of lipid-lowering drugs, sometimes the goal of therapy cannot be reached. Hence, in such patients, treatment with LDL-apheresis is indicated. Technical and clinical aspects of these five different LDL-apheresis methods are shown here. There were no significant differences with respect to or concerning all cholesterols, or triglycerides observed. With respect to elevated lipoprotein (a) levels, however, the immunoadsorption method seems to be most effective. The different published data clearly demonstrate that treatment with LDL-apheresis in patients suffering from severe hyperlipidemia refractory to maximum conservative therapy is effective and safe in long-term application.

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Human Apolipoprotein E concentration in response to diseases and therapeutic treatments

Siest

Zaiou

Visvikis

2002

Drug Development Research

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Apolipoprotein (Apo) E is an important circulating and tissular protein involved in cholesterol homeostasis and many other functions. The common polymorphism in the coding region of the gene, four polymorphisms in the promoter region, other additional single nucleotide polymorphisms, as well as several ApoE variants have been identified. Outside genetic polymorphism effects, ApoE concentration is modulated in human plasma and tissue through many processes: 1) transcription regulation through hormone responsive elements; 2) cytokines; 3) compartmentalization in particles or linkage to HSPG; 4) degradation after oxidation, glycation, and proteolysis; and 5) through many specific and nonspecific receptor interactions. Is the level of ApoE in tissue or plasma critical in different pathologies such as cardiovascular diseases (CVD) or Alzheimer's disease (AD)? ApoE is able to bind to Ab, tau, to be an antioxidant, to respond to inflammation, and is involved in cholesterol delivery, uptake, and accumulation. In experimental situations ApoE injection or positive modulation decreases cholesterol and triglycerides and improves cognitive impairment. ApoE peptides are involved in immune response. It seems more and more clear that low vs. high plasma concentration should be evaluated in large epidemiological studies. Only after such studies can the question be answered: Is a low or high concentration of ApoE beneficial or dangerous? This fascinating apolipoprotein will then be an interesting marker and/or drug target. Drug Dev. Res. 56:95-110, 2002.

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Effects of long-term treatment with simvastatin on plasma lipids and lipoproteins in patients with primary hypercholesterolemia

Cited by 11 publications

References 45 publications

Effect of simvastatin on high density lipoprotein subfractions and apolipoproteins in Type IIa hypercholesterolemia

Effect of simvastatin on high density lipoprotein subfractions and apolipoproteins in Type IIa hypercholesterolemia

LDL-Apheresis: Technical and Clinical Aspects

Human Apolipoprotein E concentration in response to diseases and therapeutic treatments

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