Effect of long-term 3-hydroxy 3-methyl glutaryl CoA reductase inhibitor therapy on lipoprotein (a) concentration / 대한내과학회지

ABSTRACT

BACKGROUND: The effect of 3-hydroxy 3-methyl glutaryl CoA reductase inhibitor (statin) on the concentration of lipoprotein (a) [Lp(a)] is controversial. Most studies evaluated the effect of statin administered for less than 2 years. We were to analyze the effect of long-term treatment of statin on the concentration of Lp(a) retrospectively. METHODS: A total 93 cases were enrolled and divided into two groups; statin group (20 mg of lovastatin, n=33) and control group (n=60). Lp(a) and lipid profiles were measured before and after the medication for at least 2 years. RESULTS: Between two groups, there were no differences in baseline clinical variables and in biochemical parameters except total cholesterol and low density lipoprotein-cholesterol (LDL-C) levels. Mean duration of follow-up was similar between control and statin groups (58.7+/-15.0 vs. 54.7+/-16.4 months, p=0.24). Lp(a) levels did not change in both statin group (30.1+/-29.6 mg/dL vs. 28.2+/-23.1 mg/dL, p=0.89) and control group (p=0.49). The change of Lp(a) was not different between two groups (p=0.43). Statin was also ineffective in cases with Lp(a) level over 10 mg/dL. Total cholesterol and LDL-C levels decreased in statin group by 26.4% (p=0.000) and 40.5% (p=0.000) respectively. The elevation of HDL-C was similar between two groups. CONCLUSION: Long-term treatment of lovastatin did not modify Lp(a) level in retrospective study. To clarify the effect of statin precisely, prospective study might be needed.