دورية أكاديمية

Effect of atorvastatin, cholesterol ester transfer protein inhibition, and diabetes mellitus on circulating proprotein subtilisin kexin type 9 and lipoprotein(a) levels in patients at high cardiovascular risk.

التفاصيل البيبلوغرافية
العنوان: Effect of atorvastatin, cholesterol ester transfer protein inhibition, and diabetes mellitus on circulating proprotein subtilisin kexin type 9 and lipoprotein(a) levels in patients at high cardiovascular risk.
المؤلفون: Arsenault, Benoit J., Petrides, Francine, Tabet, Fatiha, Bao, Weihang, Hovingh, G. Kees, Boekholdt, S. Matthijs, Ramin-Mangata, Stéphane, Meilhac, Olivier, DeMicco, David, Rye, Kerry-Anne, Waters, David D., Kastelein, John J.P., Barter, Philip, Lambert, Gilles
المصدر: Journal of Clinical Lipidology; Jan2018, Vol. 12 Issue 1, p130-136, 7p
مصطلحات موضوعية: THERAPEUTIC use of protease inhibitors, ANTILIPEMIC agents, CARDIOVASCULAR diseases risk factors, COMPARATIVE studies, STATISTICAL correlation, DIABETES, LIPOPROTEINS, LOW density lipoproteins, PLACEBOS, PROTEOLYTIC enzymes, ATORVASTATIN, DESCRIPTIVE statistics, PHARMACODYNAMICS
مستخلص: Background Proprotein subtilisin kexin type 9 (PCSK9) and lipoprotein (a) [Lp(a)] levels are causative risk factors for coronary heart disease. Objectives The objective of the study was to determine the impact of lipid-lowering treatments on circulating PCSK9 and Lp(a). Methods We measured PCSK9 and Lp(a) levels in plasma samples from Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events trial patients with coronary heart disease and/or type II diabetes (T2D) mellitus. Patients received atorvastatin, which was titrated (10, 20, 40, or 80 mg/d) to achieve low-density lipoprotein cholesterol levels <100 mg/dL (baseline) and were subsequently randomized either to atorvastatin + torcetrapib, a cholesterol ester transfer protein inhibitor, or to atorvastatin + placebo. Results At baseline, both plasma PCSK9 and Lp(a) were dose-dependently increased with increasing atorvastatin doses. Compared with patients without T2D, those with T2D had higher PCSK9 (357 ± 123 vs 338 ± 115 ng/mL, P = .0012) and lower Lp(a) levels (28 ± 32 vs 32 ± 33 mg/dL, P = .0005). Plasma PCSK9 levels significantly increased in patients treated with torcetrapib (+13.1 ± 125.3 ng/mL [+3.7%], P = .005), but not in patients treated with placebo (+2.6 ± 127.9 ng/mL [+0.7%], P = .39). Plasma Lp(a) levels significantly decreased in patients treated with torcetrapib (−3.4 ± 10.7 mg/dL [−11.1%], P < .0001), but not in patients treated with placebo (+0.3 ± 9.4 mg/dL [+0.1%], P = .92). Conclusion In patients at high cardiovascular disease risk, PCSK9 and Lp(a) are positively and dose-dependently correlated with atorvastatin dosage, whereas the presence of T2D is associated with higher PCSK9 but lower Lp(a) levels. Cholesterol ester transfer protein inhibition with torcetrapib slightly increases PCSK9 levels and decreases Lp(a) levels. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Supplemental Index
الوصف
تدمد:19332874
DOI:10.1016/j.jacl.2017.10.001