Association between cholesterol synthesis/absorption markers and effects of cholesterol lowering by atorvastatin among patients with high risk of coronary heart disease[S]

Journal of Lipid Research

Wei Wang¹  Qiang Lv¹  Jing Liu¹  Yan Li¹  Xiaohui Liu²  Dong Zhao²  Jiayi Sun²  Yue Qi³  Changsheng Ma³  Miao Wang³  Jun Liu³ 

[1] Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China;Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China;Departments of Epidemiology Capital Medical University, Beijing, China;

关键词: cholesterol synthesis marker;    cholesterol absorption marker;    low density lipoprotein cholesterol;   

DOI  :  

来源: DOAJ

【 摘 要 】

No indices are currently available to facilitate clinicians to identify patients who need either statin monotherapy or statin-ezetimibe combined treatment. We aimed to investigate whether cholesterol synthesis and absorption markers can predict the cholesterol-lowering response to statin. Total 306 statin-naïve patients with high risk of coronary heart disease (CHD) were treated with atorvastatin 20 mg/day for 1 month. Cholesterol synthesis and absorption markers and LDL cholesterol (LDL-C) levels were measured before and after treatment. Atorvastatin decreased LDL-C by 36.8% (range: decrease of 74.5% to increase of 31.9%). Baseline cholesterol synthesis marker lathosterol and cholesterol absorption marker campesterol codetermined the effect of atorvastatin treatment. The effect of cholesterol lowering by atorvastatin was significantly associated with baseline lathosterol levels but modified bidirectionally by baseline campesterol levels. In patients with the highest baseline campesterol levels, atorvastatin treatment decreased cholesterol absorption by 46.1%, which enhanced the effect of LDL-C lowering. Atorvastatin treatment increased cholesterol absorption by 52.3% in those with the lowest baseline campesterol levels, which attenuated the effect of LDL-C reduction. Especially those with the highest lathosterol but the lowest campesterol levels at baseline had significantly less LDL-C reduction than those with the same baseline lathosterol levels but the highest campesterol levels (27.3% versus 42.4%, P = 0.002). These results suggest that combined patterns of cholesterol synthesis/absorption markers, rather than each single marker, are potential predictors of the LDL-C-lowering effects of atorvastatin in high-risk CHD patients.

【 授权许可】

Unknown