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J. Lipid Res.
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Journal of Lipid Research, Vol. 43, 1701-1707, October 2002
Copyright © 2002 by Lipid Research, Inc.

Effects of atorvastatin on the HDL subpopulation profile of coronary heart disease patients

Bela F. Asztalos1,*, Katalin V. Horvath*, Judith R. McNamara*, Paul S. Roheim{dagger}, Joel J. Rubinstein§ and Ernst J. Schaefer*

* Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Center on Aging at Tufts University and Division of Endocrinology, Metabolism, Diabetes, and Molecular Medicine, New England Medical Center, Boston, MA
{dagger} Physiology Department, Louisiana State University Medical Center, New Orleans, LA
§ Cardiology Division, Newton-Wellesley Hospital, Newton, MA

1 To whom correspondence should be addressed. e-mail: basztalos{at}hnrc.tufts.edu

We investigated the effects of atorvastatin on the lipid and the apoA-I-containing HDL subpopulation profiles in 86 patients with established coronary heart disease (CHD). The entire drug treatment period lasted 12 weeks (4-week periods of 20 then 40, then 80 mg/day). Each dose of atorvastatin treatment resulted in significant reductions in plasma total-C, LDL-C, and triglyceride (TG), and non-significant increases in HDL-C levels compared with placebo treatment. ApoA-I levels did not change significantly during any of the treatment periods. Despite the modest increase of HDL-C (6%, 7%, 5%) and no change in apoA-I levels, the distribution of the apoA-I-containing HDL subpopulations changed significantly during each treatment period. There were significant increases in the concentrations of the large LpA-I {alpha}-1 (24%, 39%, 26%) and pre{alpha}-1 (51%, 61%, 63%) subpopulations at the expense of the small lipoprotein LpA-I:A-II {alpha}-3 subpopulations which decreased on all doses, and the decreases were significant on the 40 and 80 mg/day doses (6%, 5%).

Atorvastatin influences the lipid-related risk for CHD in two ways: first, it significantly decreases LDL-C and TG levels while increasing HDL-C, and second, it significantly shifts the HDL subpopulation profile of CHD patients toward that observed in subjects without CHD.

Abbreviations: apo, apolipoprotein; CHD, coronary heart disease; TG, triglyceride

Supplementary key words CHD • lipids • lipoproteins • apolipoproteins • statin


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