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Serum lipid comparison in patients treated by statins or fibrates: existence of bad HDL-C responders to statins.
Acta Cardiol. 2003 Jun; 58(3):179-84.AC

Abstract

INTRODUCTION

Major cardiac events are strongly associated with high levels of low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). The HDL-C target level (40 mg/dl) is often not achieved with statins. The aim of this study was to compare the proportions of patients achieving the HDL-C target levels after one year of treatment with statins or fibrates. Furthermore, a subgroup with low HDL-C levels during statin treatment was investigated and suggestions are made for a better management of these patients.

METHODS

A survey of lipid levels, cardiovascular disease and risk factors in 120 outpatients treated with a statin or a fibrate for hyperlipidaemia (total cholesterol (TC) > 250 mg/dl or triglycerides (TG) > 200 mg/dl after diet). After one year of treatment the proportions of patients achieving the target levels for TC, LDL-C, HDL-C,TG,TC/HDL-C and LDL-C/HDL-C are compared for statins and fibrates.

RESULTS

The proportions of patients achieving the target lipid levels with statins or fibrates are comparable except for HDL-C. Compared to the baseline, the proportion of patients achieving the HDL-C target level of 40 mg/dl increases only by 8.3% for statins and by 42.9% for fibrates. In total, 38.5% of the statin group had low HDL-C-levels after one year of treatment. Among these patients, eight were treated with a fibrate before the statin and six were treated with a fibrate afterwards. In those 14 patients, mean HDL-C increased during fibrate treatment by 48.5% and TC/HDL-C and LDL-C/HDL-C decreased by 25.7 and 26.5%, respectively as compared with statins.

CONCLUSIONS

Patients with low levels of HDL-C during statin treatment had far better levels of HDL-C, TC/HDL-C and LDL-C/HDL-C with fibrates. A randomised double-blind crossover trial with simvastatin and fenofibrate has been initiated to corroborate these findings.

Authors+Show Affiliations

Dept. of General Practice, University of Brussels (VUB), Belgium. dirk.devroey@vub.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12846506

Citation

Devroey, Dirk, et al. "Serum Lipid Comparison in Patients Treated By Statins or Fibrates: Existence of Bad HDL-C Responders to Statins." Acta Cardiologica, vol. 58, no. 3, 2003, pp. 179-84.
Devroey D, Velkeniers B, Duquet W, et al. Serum lipid comparison in patients treated by statins or fibrates: existence of bad HDL-C responders to statins. Acta Cardiol. 2003;58(3):179-84.
Devroey, D., Velkeniers, B., Duquet, W., & Betz, W. (2003). Serum lipid comparison in patients treated by statins or fibrates: existence of bad HDL-C responders to statins. Acta Cardiologica, 58(3), 179-84.
Devroey D, et al. Serum Lipid Comparison in Patients Treated By Statins or Fibrates: Existence of Bad HDL-C Responders to Statins. Acta Cardiol. 2003;58(3):179-84. PubMed PMID: 12846506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum lipid comparison in patients treated by statins or fibrates: existence of bad HDL-C responders to statins. AU - Devroey,Dirk, AU - Velkeniers,Brigitte, AU - Duquet,William, AU - Betz,Willem, PY - 2003/7/9/pubmed PY - 2003/12/3/medline PY - 2003/7/9/entrez SP - 179 EP - 84 JF - Acta cardiologica JO - Acta Cardiol VL - 58 IS - 3 N2 - INTRODUCTION: Major cardiac events are strongly associated with high levels of low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). The HDL-C target level (40 mg/dl) is often not achieved with statins. The aim of this study was to compare the proportions of patients achieving the HDL-C target levels after one year of treatment with statins or fibrates. Furthermore, a subgroup with low HDL-C levels during statin treatment was investigated and suggestions are made for a better management of these patients. METHODS: A survey of lipid levels, cardiovascular disease and risk factors in 120 outpatients treated with a statin or a fibrate for hyperlipidaemia (total cholesterol (TC) > 250 mg/dl or triglycerides (TG) > 200 mg/dl after diet). After one year of treatment the proportions of patients achieving the target levels for TC, LDL-C, HDL-C,TG,TC/HDL-C and LDL-C/HDL-C are compared for statins and fibrates. RESULTS: The proportions of patients achieving the target lipid levels with statins or fibrates are comparable except for HDL-C. Compared to the baseline, the proportion of patients achieving the HDL-C target level of 40 mg/dl increases only by 8.3% for statins and by 42.9% for fibrates. In total, 38.5% of the statin group had low HDL-C-levels after one year of treatment. Among these patients, eight were treated with a fibrate before the statin and six were treated with a fibrate afterwards. In those 14 patients, mean HDL-C increased during fibrate treatment by 48.5% and TC/HDL-C and LDL-C/HDL-C decreased by 25.7 and 26.5%, respectively as compared with statins. CONCLUSIONS: Patients with low levels of HDL-C during statin treatment had far better levels of HDL-C, TC/HDL-C and LDL-C/HDL-C with fibrates. A randomised double-blind crossover trial with simvastatin and fenofibrate has been initiated to corroborate these findings. SN - 0001-5385 UR - https://www.unboundmedicine.com/medline/citation/12846506/Serum_lipid_comparison_in_patients_treated_by_statins_or_fibrates:_existence_of_bad_HDL_C_responders_to_statins_ L2 - https://medlineplus.gov/hdlthegoodcholesterol.html DB - PRIME DP - Unbound Medicine ER -