ABSTRACT
Background: Elevated plasma lipoprotein (a) (Lp(a)) levels, which act synergistically with low-density lipoprotein cholesterol (LDL-C), are an independent risk factor for cardiovascular diseases (CVD). The effect of statin drugs on Lp(a) levels has not been well-demonstrated in clinical studies. This prospective, randomized, comparative clinical study with parallel treatment groups was conducted to assess the effect of simvastatin, atorvastatin and rosuvastatin, on serum Lp(a) levels and serum lipid profile, in treatment-naive dyslipidemic patients without CVD. Methods: A 12 weeks study, with 85 patients, aged 40-70 years, diagnosed with borderline high LDL-C, were assigned to three groups with their informed consents. Group A (n=28) was treated on simvastatin 20 mg/day; Group B (n=29) on atorvastatin 10 mg/day; and Group C (n=28) on rosuvastatin 5 mg/day. Patients’ lipid profile and Lp(a) levels were assessed at 0, 4th and 12th week of treatment period. Statistical analysis was done using Duncan’s test (p<0.05) and one-way ANOVA (p<0.001). Results: At the end of 12 weeks, serum Lp(a) reduction was substantial at 18.73% in atorvastatin group; at insignificant levels (3.15%) in simvastatin group, whereas an elevated level of 8.58% in Lp(a) was recorded in rosuvastatin group. All three treatment groups showed a significant positive impact on the lipid profile. No adverse drug reactions were reported. Conclusion: The impact of statin monotherapy on lipid profile doesn’t correlate with its effect on Lp(a). Atorvastatin has shown a significant reduction in Lp(a) unlike the other statins, and should be preferred in patients with increased risk of CVD.