Patients (n = 40) with hypercholesterolaemia (29 females), mean age 63 years, without previous lipid lowering treatment, were treated with atorvastatin 40 mg/day for 3 months. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), LDL-C subfractions (large LDL-C and small dense LDL-C particles), apolipoprotein A1 (apo A1), apolipoprotein B (apo B), apo B/apo A1 ratio, atherogenic index of plasma (AIP), haematological parameters including mean platelet volume (MPV), and red cell distribution width (RDW) and safety parameters (renal and hepatic function) were measured before and after 12 weeks of atorvastatin treatment. Atorvastatin significantly reduced small dense LDL (sdLDL) fraction 3–7 and apo B. There was a negative correlation of AIP with buoyant LDL 1–2 (r = −0.35; p < 0.05) and positive with small dense LDL 3–7 (r = 0.52, p < 0.001). Administration of atorvastatin 40 mg/day in patients with hypercholesterolaemia caused a shift in small dense LDL subfractions to large, buoyant subfractions. AIP correlated better with small dense LDL than apo B levels. At baseline, a strong correlation between HDL-C, TG, small dense LDL-C, apo B, apo B/apo A1 and AIP with MPV was found. After 12 weeks of treatment with atorvastatin, MPV and RDW values underwent significant modification only in those patients displaying the strongest lipid-lowering effect. Values of MPV and RDW seem to reflect a pro-atherogenic lipoprotein profile mainly represented by the presence of small dense LDL-C. No serious atorvastatin adverse events were noted.
Part of the book: Cholesterol Lowering Therapies and Drugs