title: "Essential" phospholipids versus nicotinic acid in the treatment of patients with type IIb hyperlipoproteinemia and ischemic heart disease.
abstract: In patients with moderate, dietary noncorrigible hyperlipoproteinemia type IIb and ischemic heart disease, treatment with nicotinic acid is limited by the side effects of the drug. In 100 patients, 6-month treatment with nicotinic acid (n = 50) or "essential" phospholipids (EPL); Lipostabil, manufacturer: Rhône-Poulenc Rorer) (n = 50) indicated comparable efficacy for both substances: Significant (p < .001) reductions of serum total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride values were similar in both groups, while nicotinic acid increased high-density lipoprotein (HDL) cholesterol significantly (p < .01) better than Lipostabil. A detailed analysis of ultracentrifugal lipoprotein profiles, hydroperoxide concentrations in LDL, and cholesterol-accepting properties of HDL in a small number of Lipostabil- and nicotinic acid-treated patients revealed favorable shifts in the lipoprotein profile, significant (p < .05) reductions of LDL hydroperoxides, and favorable increases of the most antiatherogenic HDL2b subfraction only in the Lipostabil-treated group. Clinically, both medications reduced the intensity and number of angina pectoris attacks per week (p < .05), but only Lipostabil-treated patients significantly (p < .05) increased their working capacity in the veloergometric test. Since in the nicotinic acid-treated group dropouts (nine patients, eight related to the drug) and side effects [14] exceeded those in the Lipostabil-treated group (two dropouts not related to the drug, no side effects), it is suggested that Lipostabil is a preferable alternative in the treatment of patients with moderate, dietary noncorrigible hyperlipoproteinemia IIb and ischemic heart disease.
authors.affiliation: Institute of Experimental Medicine, St. Petersburg, Russia.
authors.forename: A N
authors.initials: AN
authors.lastname: Klimov
authors.forename: V O
authors.initials: VO
authors.lastname: Konstantinov
authors.forename: B M
authors.initials: BM
authors.lastname: Lipovetsky
authors.forename: A S
authors.initials: AS
authors.lastname: Kuznetsov
authors.forename: V T
authors.initials: VT
authors.lastname: Lozovsky
authors.forename: V F
authors.initials: VF
authors.lastname: Trufanov
authors.forename: S L
authors.initials: SL
authors.lastname: Plavinsky
authors.forename: K J
authors.initials: KJ
authors.lastname: Gundermann
authors.forename: R
authors.initials: R
authors.lastname: Schumacher
mesh_terms: D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D009525:Niacin / Q000627:therapeutic use*; D010713:Phosphatidylcholines / Q000627:therapeutic use*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005217:Fat Emulsions, Intravenous; D010713:Phosphatidylcholines; C005152:lipostabil; D009525:Niacin