Moderate statin treatment reduces prebeta-1 high-density lipoprotein levels in dyslipidemic patients

• Published in: Journal of clinical lipidology Vol. 11; no. 4; pp. 908 - 914
• Main Authors: Quinn, Alex G., BS, Schwemberger, Rachel, BS, Stock, Eveline Oestreicher, MD, Movsesyan, Irina, BS, Axtell, Andrea, MD, Chang, Sunny, MD, Ishida, Brian Y., PhD, Malloy, Mary J., MD, Kane, John P., MD, PhD, Pullinger, Clive R., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2017
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular; Dose-Response Relationship, Drug; Dyslipidemia; Dyslipidemias - blood; Dyslipidemias - drug therapy; Female; HDL; High-Density Lipoproteins, Pre-beta - blood; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; LDL; Lipoproteins; Male; Middle Aged; Prebeta-1 HDL; Reverse cholesterol transport; Statin treatment; Treatment Outcome; Triglycerides; Young Adult; HDL; Prebeta-1 HDL; Lipoproteins; LDL; Dyslipidemia; Reverse cholesterol transport; Statin treatment; Triglycerides
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2017.04.118

Background Elevated plasma levels of prebeta-1 high-density lipoprotein (HDL), the principal acceptor of cholesterol effluxed from macrophages, are associated with increased risk of atherosclerotic coronary heart disease and myocardial infarction. Objective The objective of the study was to assess the effects on prebeta-1 HDL levels of 6-week moderate-dose statin treatment. Methods We studied 101 patients (mean age 52.7 years; 53.5% female; 63 with primary hypercholesterolemia; 38 with combined hyperlipidemia) before and after treatment with statins. Mean atorvastatin potency equivalence was 23.6 mg/d. Prebeta-1 HDL plasma levels were measured by immunofixation of agarose gels using anti-apolipoprotein A-1 antibody. Results We observed a 42.0% reduction of low-density lipoprotein cholesterol (181 ± 56 vs 105 mg/dL, P  < .001). Triglyceride (TG) levels decreased by 22.3% (157 vs 122 mg/dL, P  < .001), HDL cholesterol levels remained similar (56.0 vs 57.1, P  = NS). Levels of prebeta-1 HDL were significantly reduced by 17.9% after statin treatment (mean 11.4 vs 9.4 mg apoA-1/dL, P  < .001). The magnitude of this decrease was similar with each of 3 statins (atorvastatin, simvastatin, and rosuvastatin). The decrease in prebeta-1 HDL was strongly associated with the decline in TG, but not with the decline in low-density lipoprotein cholesterol. Conclusions The association of high prebeta-1 HDL with coronary heart disease identifies it as an inferential measure of the rate of cholesterol efflux from the artery wall. Our observations demonstrate a reduction of prebeta-1 HDL with statin therapy, partially reflecting the reduced TGs, and probably reflecting a direct beneficial impact on cholesterol efflux.