Baseline lipid values partly determine the response to high-dose simvastatin in patients with familial hypercholesterolemia - The examination of probands and relatives in Statin studies with familial hypercholesterolemia (ExPRESS FH)

Pernette R. W. de Sauvage Nolting, Rudolf J. A. Buirma, Barbara A. Hutten, John J. P. Kastelein

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Abstract

Statins decrease low-density lipoprotein cholesterol (LDL-C), and additionally, reduce triglycerides (TG) and raise high-density lipoprotein cholesterol (HDL-C) levels. This study evaluated the frequency of abnormal TG and HDL-C levels in patients with classical familial hypercholesterolemia (FH) and assessed therapeutic response at different baseline levels of these lipoproteins after 1 year of statin therapy. A total of 508 FH patients were included and mean LDL-C levels (8.37 +/- 2.12 mmol l(-1)) were severely elevated. After a washout period of 6 weeks, all patients started monotherapy with 80 mg simvastatin. Remarkably, LDL-C reduction was dependent on baseline LDL-C levels ranging from 51.1 to 45.5% in the top versus the bottom third of the LDL-C distribution. Unexpected in FH, elevated baseline TG levels were seen in 30% and low HDL-C levels in 15% of all patients. Also, changes in these lipoproteins were dependent on baseline levels; TG reduction was 40.7 versus 22.2% in patients with elevated versus normal levels, while HDL-C increase was 29.1 versus 11.4% in patients with low versus normal HDL-C levels. In conclusion, FH patients with the worst lipoprotein profile showed the greatest benefit from high-dose simvastatin treatment, since changes in these parameters were partly determined by baseline lipid levels. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
Original languageEnglish
Pages (from-to)347-354
JournalAtherosclerosis
Volume164
Issue number2
Publication statusPublished - 2002

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