Effects of acipimox on haemorheology and plasma lipoproteins in patients with mixed hyperlipoproteinaemia

Otto, Carsten; Parhofer, KG; Mm, Ritter; Wo, Richter; Schwandt, P.

doi:10.1046/j.1365-2125.1998.00816.x

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…HDL cholesterol has been shown to be a possible link between dyslipoproteinemias and impaired flow properties, since HDL cholesterol is inversely correlated with red cell aggregation (17,18). In previous studies we observed an improvement of the red cell aggregation index when HDL cholesterol concentration increased with gemfibrozil (19), with the nicotinic acid derivate acipimox (20), and seasonally in summer (21). In the present study we analogously found a small increase in red cell aggregation associated with a slight decrease in HDL cholesterol during atorvastatin in comparison with simvastatin therapy.…”

Section: Discussionmentioning

confidence: 76%

Influence of Atorvastatin Versus Simvastatin on Fibrinogen and Other Hemorheological Parameters in Patients with Severe Hypercholesterolemia Treated with Regular Low‐Density Lipoprotein Immunoadsorption Apheresis

Otto¹,

Geiss²,

Donner³

et al. 2000

Therapeutic Apheresis

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Low-density lipoprotein (LDL) apheresis is a treatment option in patients with coronary artery disease and elevated LDL cholesterol concentrations if maximal drug therapy fails to achieve adequate LDL cholesterol reduction. This therapy is more effective when combined with strong lipid-lowering drugs, such as atorvastatin. However, conflicting data have been published concerning the effect of atorvastatin on fibrinogen concentration. Therefore, we investigated the effect of atorvastatin compared to simvastatin on fibrinogen concentration and other hemorheological parameters in patients treated by weekly LDL apheresis. Hemorheological parameters were, studied twice in 9 patients (4 female, 5 male, 54.0+/-8.9 years) with coronary artery disease treated by weekly LDL immunoadsorption, once during concomitant simvastatin therapy (40 mg daily) and once during atorvastatin therapy (40 mg daily). Fibrinogen concentration, plasma and blood viscosity at different shear rates, parameters of red cell aggregation at stasis and shear rate 3/s, and erythrocyte filterability were determined 7 days after the last LDL apheresis after each drug had been given for a minimum for 8 weeks. Fibrinogen concentration did not show any statistically significant difference during therapy with atorvastatin (3.09+/-0.36 g/L) compared to simvastatin (3.13+/-0.77 g/L). Plasma and blood viscosity as well as erythrocyte filterability were also unchanged. The increase in red cell aggregation at stasis during atorvastatin treatment (5.82+/-1.00 U versus 4.89+/-0.48 U during simvastatin; p < 0.05) was inversely correlated with a lower high-density liprotein (HDL) cholesterol concentration (1.17+/-0.21 mmol/L versus 1.31+/-0.30 mmol/L during simvastatin; p < 0.05). LDL cholesterol showed a strong trend to lower concentrations during atorvastatin (4.14+/-0.61 mmol/L versus 4.56+/-0.66 mmol/L during simvastatin; p = 0.07), despite a reduced plasma volume treated (3,547+/-1,239 ml during atorvastatin versus 3,888+/-1,206 mL during simvastatin; p < 0.05). In conclusion, fibrinogen concentration and other hemorheological parameters were unchanged during atorvastatin compared to simvastatin therapy with the exception of a higher red cell aggregation at stasis. Therefore, with respect to hemorheology, we conclude that atorvastatin should not be withheld from hypercholesterolemic patients regularly treated with LDL immunoadsorption.

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Section: Discussionmentioning

confidence: 76%

Influence of Atorvastatin Versus Simvastatin on Fibrinogen and Other Hemorheological Parameters in Patients with Severe Hypercholesterolemia Treated with Regular Low‐Density Lipoprotein Immunoadsorption Apheresis

Otto¹,

Geiss²,

Donner³

et al. 2000

Therapeutic Apheresis

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“…The acute plasma triglyceride lowering effect of Acipimox in diabetic patients [19, present study] is sustained with long‐term treatment [20–22]. HDL cholesterol remains unchanged [20–22] or tends to increase [23–25] with its prolonged use. Although hypertriglyceridaemia is an independent cardiovascular risk factor [26], the potential cardioprotective effect of Acipimox remains to be proven.…”

Section: Discussionmentioning

confidence: 98%

Short‐term Acipimox decreases the ability of plasma from Type 2 diabetic patients and healthy subjects to stimulate cellular cholesterol efflux: a potentially adverse effect on reverse cholesterol transport

Dullaart¹,

Tol

2001

Diabetic Medicine

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Short-term Acipimox administration impairs the ability of plasma from Type 2 diabetic patients and healthy subjects to stimulate cellular cholesterol efflux, in conjunction with alterations in HDL parameters and in PLTP activity. If the impairment of cellular cholesterol efflux to plasma is sustained with long-term treatment, this potentially adverse effect should be considered when treating diabetic dyslipidaemia with Acipimox. Diabet. Med. 18, 509-513 (2001)

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Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds

Birjmohun¹,

Hutten

Kastelein³

et al. 2005

Journal of the American College of Cardiology

399

249

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Fibrates reduce major coronary events and increase HDL-C levels without significant toxicity. Niacin has a more potent effect on HDL-C levels, whereas data on cardiovascular event rate reduction are limited. Future studies need to evaluate whether additional HDL increase by fibrates or particularly newer niacin formulations on top of statin therapy translates into further event reduction in high-risk subjects, without significant toxicity.

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Effects of acipimox on haemorheology and plasma lipoproteins in patients with mixed hyperlipoproteinaemia

Abstract: We conclude, that the cardiovascular risk profile improves during acipimox therapy due to an elevation in HDL cholesterol and its subfractions as well as a decrease in red cell aggregation.

Cited by 5 publications

References 36 publications

Influence of Atorvastatin Versus Simvastatin on Fibrinogen and Other Hemorheological Parameters in Patients with Severe Hypercholesterolemia Treated with Regular Low‐Density Lipoprotein Immunoadsorption Apheresis

Influence of Atorvastatin Versus Simvastatin on Fibrinogen and Other Hemorheological Parameters in Patients with Severe Hypercholesterolemia Treated with Regular Low‐Density Lipoprotein Immunoadsorption Apheresis

Short‐term Acipimox decreases the ability of plasma from Type 2 diabetic patients and healthy subjects to stimulate cellular cholesterol efflux: a potentially adverse effect on reverse cholesterol transport

Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds

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