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European Heart Journal 1988 9(5):541-551;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Effects of simvastatin on plasma lipid, lipoprotein and apolipoprotein concentrations in hypercholesterolaemia

J. MöLGAARD*, H. VON SCHENCK{dagger} and A. G. OLSSON*

*Departments of Internal Medicine and Linköping University Hospital S-581 85 Linköping, Sweden
{dagger}Clinical Chemistry, Linköping University Hospital S-581 85 Linköping, Sweden

Received 9 July 1987; revised 7 August 1987; .

Author for correspondence: Jorgen Molgaard, Department of Internal Medicine, Linköping University Hospital, S-581 85 Linköping, Sweden.

Abstract

The effect of 24 weeks of treatment with simvastatin, a new HMG coenzyme A reductase inhibitor (dosages of 20 and40 mg day–1) on serum lipid, lipoprotein and apolipoprotein A-I and B concentrations as well as safety parameters and subjective side effects were studied in 11 patients with familial (FH) and 10 patients with polygenic hypercholesterolaemia (P-HC). The effects on plasma lipoprotein and apolipoprotein concentrations had already been achieved after four weeks in both groups and then remained during the study. In FH, mean fasting plasma total cholesterol concentration decreased from 10·51 to 6·71 mmol l–1 (36%), and in P-HC from 6·55 to 4·54 mmol l–1 (31%) at 24 weeks (P<0·001). Mean plasma low density lipoprotein (LDL) cholesterol concentrations also decreased, in FH from 8·87 to 5·05 mmol l–1 (43%) and in P-HC from 4–97 to 3–12 mmol l–1 (37%) at 24 weeks (P<0·001). Furthermore, apolipoprotein B concentrations decreased significantly from 2·21 to 1·57 g l–1 (29%)(P<0·001) in FH and from 1·53 to 1·09 g l–1 (29%) (P<0·01) in P-HC. Plasma high density lipoprotein (HDL) cholesterol increased in both FH and P-HC during treatment. Increases were seen in both the subfractions HDL2 and HDL3. Simvastatin was well tolerated. No serious clinical or laboratory adverse effects were observed. It is concluded that 24 weeks of treatment with simvastatin in doses up to 40 mg day–1 effectively reduces plasma total and LDL cholesterol concentrations without causing subjective or significant objective side effects. Thus, simvastatin may be of great interest in future studies for prevention of coronary heart disease due to hypercholesterolaemia.

Key Words: Apolipoprotein A-I • apolipoprotein B • HMG-CoA reductase inhibitor • hypercholesterolaemia • lipoproteins • plasma cholesterol • plasma triglycerides • simvastatin


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