Linked Life Data

21115572

Source:http://linkedlifedata.com/resource/pubmed/id/21115572

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
Pt 1
pubmed:dateCreated
2011-1-28
pubmed:abstractText
Statins are agents widely used to lower LDL-cholesterol (LDL-C) in primary and secondary prevention of coronary heart disease. The five statins available in the UK (simvastatin, pravastatin, fluvastatin, atorvastatin and rosuvastatin) differ in many of their pharmacologic properties. In addition to lowering LDL-C, statins also increase HDL-cholesterol (HDL-C) moderately. There have been rare reports of significant HDL-C decreases in patients commenced on fibrates and when thiazolidinediones are added to fibrates. This is known as a 'paradoxical HDL-C decrease' as both groups of agents usually increase HDL-C. This phenomenon has never been clearly documented following statin therapy. We now describe a patient with type 2 diabetes who showed this paradoxical fall in HDL-C (baseline HDL-C: 1.8 mmol/L; on simvastatin 40 mg HDL-C 0.6 mmol/L; on atorvastatin 20 mg HDL-C 0.9 mmol/L) with a similar decrease in apolipoprotein A1. No similar decrease was observed with pravastatin and rosuvastatin therapy. This phenomenon appeared to be associated with statin treatment and not a statin/fibrate combination. Our patient clearly demonstrated a paradoxical HDL-C fall with simvastatin and atorvastatin, but not pravastatin or rosuvastatin. Simvastatin and atorvastatin share many pharmacokinetic properties such as lipophilicity while pravastatin and rosuvastatin are relatively hydrophilic and are not metabolized by cytochrome P450 3A4. However, these characteristics do not explain the dramatic reductions in HDL-C observed.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
http://linkedlifedata.com/resource/pubmed/chemical/Apolipoprotein A-I, http://linkedlifedata.com/resource/pubmed/chemical/Cholesterol, HDL, http://linkedlifedata.com/resource/pubmed/chemical/Cholesterol, LDL, http://linkedlifedata.com/resource/pubmed/chemical/Fluorobenzenes, http://linkedlifedata.com/resource/pubmed/chemical/Heptanoic Acids, http://linkedlifedata.com/resource/pubmed/chemical/Hydroxymethylglutaryl-CoA..., http://linkedlifedata.com/resource/pubmed/chemical/Pravastatin, http://linkedlifedata.com/resource/pubmed/chemical/Pyrimidines, http://linkedlifedata.com/resource/pubmed/chemical/Pyrroles, http://linkedlifedata.com/resource/pubmed/chemical/Simvastatin, http://linkedlifedata.com/resource/pubmed/chemical/Sulfonamides, http://linkedlifedata.com/resource/pubmed/chemical/atorvastatin, http://linkedlifedata.com/resource/pubmed/chemical/rosuvastatin
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1758-1001
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
48
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
75-8
pubmed:meshHeading
pubmed:year
2011
pubmed:articleTitle
Paradoxical decrease in HDL-cholesterol and apolipoprotein A1 with simvastatin and atorvastatin in a patient with type 2 diabetes.
pubmed:affiliation
Department of Clinical Biochemistry, Good Hope Hospital, Heart of England Foundation Trust, Sutton Coldfield, West Midlands, UK. sud.ramachandran@heartofengland.nhs.uk
pubmed:publicationType
Journal Article, Case Reports