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Effects of atorvastatin on Lp(a) and lipoprotein profiles in hemodialysis patients.
Ann Pharmacother. 2008 Jan; 42(1):9-15.AP

Abstract

BACKGROUND

Dialysis patients have many underlying traditional and nontraditional risk factors that may predispose them to a high prevalence of cardiovascular disease. The effects of statins (eg, atorvastatin) on altering nontraditional lipoprotein measures in dialysis patients have not been extensively investigated.

OBJECTIVE

To evaluate the efficacy of atorvastatin compared with a control group in inducing changes in lipoprotein(a) [Lp(a)], apolipoprotein (Apo) A-1, Apo-B, and fibrinogen levels, as well as the conventional lipoprotein profile, in hemodialysis patients over 36 weeks; secondary objectives were to assess changes in C-reactive protein, albumin, and safety measures.

METHODS

Forty-five hemodialysis patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 100 mg/dL were randomized to parallel groups: atorvastatin (n = 19) or no treatment (n = 26). The atorvastatin dose was titrated from 10 mg to achieve an LDL-C goal of 100 mg/dL or less and therapy was continued for 36 weeks. Biochemical and lipoprotein laboratory tests for efficacy outcomes were obtained at baseline, 12 weeks, and 36 weeks.

RESULTS

The atorvastatin group exhibited clinically significant reductions (mean +/- SD) compared with controls in total cholesterol (-21.7 +/- 41.7 vs -3.2 +/- 40.0 mg/dL, respectively; p = 0.017) and LDL-C (-13.1 +/- 32.0 vs -1.1 +/- 38.4 mg/dL, respectively; p = 0.058) levels, as well as Lp(a) (-10.6 +/- 27 vs 3.5 +/- 17.8 mg/dL, respectively; p = 0.046). Statistical analyses included analysis of variance on ranked measures for multivariable modeling and paired t-test to determine changes in efficacy measures between baseline and 36 weeks within groups.

CONCLUSIONS

Atorvastatin was safe and effective in reducing Lp(a), total cholesterol, and LDL-C levels. Given the prevalence of atherosclerosis in hemodialysis patients, therapy aimed at reducing traditional and nontraditional risk factors may be beneficial.

Authors+Show Affiliations

Division of Nephrology and Hypertension, School of Medicine, University of North Carolina Kidney Center, University of North Carolina, Chapel Hill, NC 27599, USA. Melanie_Joy@med.unc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18000162

Citation

Joy, Melanie S., et al. "Effects of Atorvastatin On Lp(a) and Lipoprotein Profiles in Hemodialysis Patients." The Annals of Pharmacotherapy, vol. 42, no. 1, 2008, pp. 9-15.
Joy MS, Dornbrook-Lavender KA, Chin H, et al. Effects of atorvastatin on Lp(a) and lipoprotein profiles in hemodialysis patients. Ann Pharmacother. 2008;42(1):9-15.
Joy, M. S., Dornbrook-Lavender, K. A., Chin, H., Hogan, S. L., & Denu-Ciocca, C. (2008). Effects of atorvastatin on Lp(a) and lipoprotein profiles in hemodialysis patients. The Annals of Pharmacotherapy, 42(1), 9-15.
Joy MS, et al. Effects of Atorvastatin On Lp(a) and Lipoprotein Profiles in Hemodialysis Patients. Ann Pharmacother. 2008;42(1):9-15. PubMed PMID: 18000162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of atorvastatin on Lp(a) and lipoprotein profiles in hemodialysis patients. AU - Joy,Melanie S, AU - Dornbrook-Lavender,Kimberly A, AU - Chin,Hyunsook, AU - Hogan,Susan L, AU - Denu-Ciocca,Cynthia, Y1 - 2007/11/13/ PY - 2007/11/15/pubmed PY - 2008/1/26/medline PY - 2007/11/15/entrez SP - 9 EP - 15 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 42 IS - 1 N2 - BACKGROUND: Dialysis patients have many underlying traditional and nontraditional risk factors that may predispose them to a high prevalence of cardiovascular disease. The effects of statins (eg, atorvastatin) on altering nontraditional lipoprotein measures in dialysis patients have not been extensively investigated. OBJECTIVE: To evaluate the efficacy of atorvastatin compared with a control group in inducing changes in lipoprotein(a) [Lp(a)], apolipoprotein (Apo) A-1, Apo-B, and fibrinogen levels, as well as the conventional lipoprotein profile, in hemodialysis patients over 36 weeks; secondary objectives were to assess changes in C-reactive protein, albumin, and safety measures. METHODS: Forty-five hemodialysis patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 100 mg/dL were randomized to parallel groups: atorvastatin (n = 19) or no treatment (n = 26). The atorvastatin dose was titrated from 10 mg to achieve an LDL-C goal of 100 mg/dL or less and therapy was continued for 36 weeks. Biochemical and lipoprotein laboratory tests for efficacy outcomes were obtained at baseline, 12 weeks, and 36 weeks. RESULTS: The atorvastatin group exhibited clinically significant reductions (mean +/- SD) compared with controls in total cholesterol (-21.7 +/- 41.7 vs -3.2 +/- 40.0 mg/dL, respectively; p = 0.017) and LDL-C (-13.1 +/- 32.0 vs -1.1 +/- 38.4 mg/dL, respectively; p = 0.058) levels, as well as Lp(a) (-10.6 +/- 27 vs 3.5 +/- 17.8 mg/dL, respectively; p = 0.046). Statistical analyses included analysis of variance on ranked measures for multivariable modeling and paired t-test to determine changes in efficacy measures between baseline and 36 weeks within groups. CONCLUSIONS: Atorvastatin was safe and effective in reducing Lp(a), total cholesterol, and LDL-C levels. Given the prevalence of atherosclerosis in hemodialysis patients, therapy aimed at reducing traditional and nontraditional risk factors may be beneficial. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/18000162/Effects_of_atorvastatin_on_Lp_a__and_lipoprotein_profiles_in_hemodialysis_patients_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1K407?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -