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Apolipoprotein(a) polymorphism predicts the increase of Lp(a) by pravastatin in patients with familial hypercholesterolaemia treated with bile acid sequestration
Author(s) -
KLAUSEN I. C.,
GERDES L. U.,
MEINERTZ H.,
HANSEN F. A.,
FAERGEMAN O.
Publication year - 1993
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1993.tb00768.x
Subject(s) - pravastatin , medicine , apolipoprotein b , hydroxymethylglutaryl coa reductase , endocrinology , reductase , placebo , lipoprotein , hmg coa reductase , cholesterol , lipoprotein(a) , bile acid , familial hypercholesterolemia , chemistry , biochemistry , enzyme , alternative medicine , pathology
. HMG‐CoA reductase inhibitors effectively reduce the concentration of low density lipoproteins (LDL) in plasma. Lipoprotein(a) [Lp(a)] may be as atherogenic as LDL. A few studies, only one of which was placebo controlled, suggest that the HMG CoA reductase inhibitors either do not affect Lp(a) or they increase Lp(a). The response of Lp(a) to HMG‐CoA reductase inhibition has not been related to apolipo‐protein(a) phenotypes in previous studies. We conducted a double‐blind, placebo controlled study of pravastatin in 51 patients with familial hypercholester‐olemia (FH) ( n = 43) or probable FH ( n = 8). All patients had LDL‐cholesterol concentrations above 4.1 mmol 1 ‐1 despite treatment with diet and bile acid sequestration. In patients assigned to pravastatin ( n = 34), the mean concentrations of total cholesterol and LDL cholesterol fell significantly ( P< 0.01) when compared to placebo. Lp(a) increased ( P< 0.01) from a mean (±SD) of 33.6 ± 40.8 mgdl ‐1 to 411 ± 46.1 mg dl ‐1 on pravastatin but was unchanged during placebo treatment. The percentage increase in Lp(a) was the same in patients with different apo(a) phenotypes, and hence the absolute increase in Lp(a) was greatest in patients with the low molecular weight apo(a) phenotypes.