Effects of lovastatin on ApoA- and ApoB-containing lipoproteins. Families in a subpopulation of patients participating in the Monitored Atherosclerosis Regression Study (MARS).
To establish whether lovastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, exhibits a specific effect on apolipoprotein (apo) A- and apoB-containing lipoproteins, 63 subjects, a subset of the 270 Monitored Atherosclerosis Regression Study (MARS) patients with hypercholesterolemia (190 to 295 mg/dL) and documented coronary artery disease, were randomized into either lovastatin 40 mg twice daily or matching placebo tablets twice daily. Both groups consumed a diet containing 27% calories as fat (polyunsaturated fat/saturated fat ratio, 2.85) and a daily cholesterol intake of less than 250 mg. The plasma lipid and apolipoprotein profiles were determined at the time of randomization and after 2 years of treatment, and the levels of apoA- and apoB-containing lipoprotein families were measured after 2 years of treatment. After this treatment period, the drug group was characterized in comparison with the placebo group by significantly reduced levels of total cholesterol (33%), triglycerides (30%), very-low-density lipoprotein cholesterol (36%), low-density lipoprotein cholesterol (43%), apoB (36%), apoC-III (18%), and apoE (17%) and slightly but insignificantly increased levels of high-density lipoprotein cholesterol (6%) and apoA-I (1%). The 2-year levels of lipoprotein containing apoA-I but no apoA-II (LpA-I) and lipoprotein containing both apoA-I and apoA-II (LpA-I/A-II) particles separated by immunoaffinity chromatography on an anti-apoA-II immunosorber did not differ between the two treatment groups. However, the apoB-containing lipoprotein (Lp) families defined by apolipoprotein composition and separated by immunoaffinity chromatography on anti-apoA-II and anti-apoC-III immunosorbers were affected in a selective manner.(ABSTRACT TRUNCATED AT 250 WORDS)
Alaupovic
P
P
Lipid and Lipoprotein Laboratory, Oklahoma Medical Research Foundation, Oklahoma City 73104.
Hodis
H N
HN
Knight-Gibson
C
C
Mack
W J
WJ
LaBree
L
L
Cashin-Hemphill
L
L
Corder
C N
CN
Kramsch
D M
DM
Blankenhorn
D H
DH
D000328:Adult; D000368:Aged; D001054:Apolipoproteins A / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy / Q000235:genetics*; D018450:Disease Progression; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000188:drug therapy / Q000235:genetics*; D008148:Lovastatin / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
D001054:Apolipoproteins A; D001055:Apolipoproteins B; D014280:Triglycerides; D002784:Cholesterol; D008148:Lovastatin