Combined hyperlipidemia in a single subject with tetraplegia: ineffective risk reduction after atorvastatin monotherapy.
OBJECTIVE
Effects of atorvastatin (Lipitor) drug monotherapy (10 mg daily) on fasting blood lipid profiles and cardiovascular disease (CVD) risks were examined for a single subject with C5-C6 tetraplegia. Routine fasting lipid profiles were analyzed by standard biochemistry techniques for total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Lipid profiles were analyzed on 3 occasions before drug therapy was initiated and 3 months after therapy commenced. The TC:HDL and LDL:HDL ratios were computed for all sampling times and used to assess pretreatment and post-treatment CVD risk.


RESULTS
Fasting TC, TG, and LDL-C were all significantly reduced by therapy. The pretreatment HDL-C of 35 mg/dL was lowered to 21 mg/dL. As a result, the TC:HDL risk ratio was only marginally reduced from 6.6 to 6.4, whereas the LDL:HDL risk ratio remained unchanged by treatment.


CONCLUSIONS
In this man with tetraplegia, atorvastatin drug monotherapy rapidly lowered TC, TG, LDL-C, and HDL-C. However, the TC:HDL ratio, considered the best predictor of CVD risk, was unchanged.
Nash
Mark S
MS
Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA. msnash@miami.edu
Johnson
Brad M
BM
Jacobs
Patrick L
PL
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D002574:Cervical Vertebrae / Q000293:injuries; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006950:Hyperlipidemia, Familial Combined / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D016017:Odds Ratio; D011758:Pyrroles / Q000627:therapeutic use*; D013119:Spinal Cord Injuries / Q000097:blood*; D017211:Treatment Failure; D014280:Triglycerides / Q000097:blood; D014948:Wounds, Gunshot / Q000097:blood*
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D014280:Triglycerides; D002784:Cholesterol; D000069059:Atorvastatin