xidized low-density lipoprotein (LDL) plays a key role in the initiation and development of atherosclerosis through a variety of effects, such as recruitment of monocytes, adhesion of leukocytes to endothelial cells, promotion of intraluminal thrombosis, activation of lymphocytes, enhanced cytotoxicity, and impairment of endothelium-dependent vasorelaxation. [1][2][3][4] It has become possible to measure the serum concentrations of oxidized LDL or malondialdehyde-modified LDL (MDA-LDL) 5-11 and their circulating concentrations have been reported to be significantly higher in patients with coronary artery disease (CAD) than in controls. 9-11 Sasaki et al reported that atorvastatin decreased the serum concentration of MDA-LDL in patients with mixed hyperlipoproteinemia 12 and although atorvastatin produces greater reductions in the serum concentrations of total and LDL cholesterol than other statins, such as simvastatin, pravastatin, lovastatin, and fluvastatin, 13 it is unclear whether this statin has more effect on decreasing the serum concentrations of MDA-LDL than other statins. In the present study, we compared the effects of atorvastatin and pravastatin on the serum concentrations of MDA-LDL in hypercholesterolemic patients.
Methods
Study PopulationThe study patients consisted of 17 patients (10 men, 7women; mean age, 68±9 years) who were indicated for drug therapy based on the National Cholesterol Education Program II. 14 Exclusion criteria were: (1) use of anti-inflammatory or lipid-lowering drugs or antioxidant supplements, (2) currently smoking, (3) renal or liver dysfunction, (4) diabetes mellitus, (5) the presence of angina attacks, (6) a history of stroke or acute coronary syndrome within 6 months, (7) a history of coronary interventional therapy within the past year, (8) chronic heart failure, (9) collagen disease, infection, malignant diseases, or recent (<6 months) major surgery or trauma, and (10) change in the drugs administered within the 3 months prior to registration in the study.
Study ProtocolThe study protocol is shown in Fig 1. It was a randomized crossover design and the study started 1 month after registration. The patients underwent an 8-week regimen of statin therapy of either atorvastatin (10 mg/day) or pravastatin (10 mg/day) with a 4-week washout period between drugs. The study protocol was in agreement with the guidelines of the institutional ethics committee and informed consent was obtained from each patient prior to enrollment in the study.After an overnight fast, venous blood samples were obtained before and after the 8-week treatment with atorvastatin or pravastatin. The concentrations of LDL cholesterol, triglycerides, and HDL cholesterol were assayed by enzymatic methods. Serum concentrations of MDA-LDL were measured using an enzyme immunoassay kit (SRL, Inc, Tokyo, Japan). Intra-and inter-assay variations were within 3.5% and 6.9%, respectively.
Statistical AnalysisAll data are expressed as means ± SD. Paired t test was
Effects of Atorvastatin and Pravastatin on Malondiald...