title: Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans.
abstract: BACKGROUND
  As statin therapy has been reported to reduce antioxidants such as vitamin E and coenzyme Q10 and there are indications that this reduction may cause impairment of left ventricular function (LVF), we studied the influence of simvastatin on LVF and serum vitamin E and coenzyme Q10 levels in humans.
  
  
  METHODS
  We assessed the effect of simvastatin on left ventricular function and coenzyme Q10 levels in 21 (11 male, 10 female) hypercholesterolaemic subjects (mean age = 56 years) with normal LVF, over a period of 6 months. Subjects were re-tested after a 1-month wash-out period (7 months). Echocardiography was performed on all subjects before commencement of simvastatin (20 mg day(-1)), and at 1, 3, 6 and 7 months after initiation of treatment. Fasting blood samples were also collected at these intervals to assess lipids, apoproteins, vitamin E and coenzyme Q10.
  
  
  RESULTS
  Serum lipids showed the expected reductions. Plasma vitamin E and coenzyme Q10 levels were reduced by 17 +/- 4% (P < 0.01) and 12 +/- 4% (P < 0.03) at 6 months. However, the coenzyme Q10/LDL-cholesterol ratio and vitamin E/LDL-cholesterol ratio increased significantly. Left ventricular ejection fraction (EF) decreased transiently after 1 month, while no significant change was observed at 3 and 6 months. Other markers of left ventricular function did not change significantly at any time point.
  
  
  CONCLUSIONS
  Despite reduced plasma vitamin E and coenzyme Q10, 20 mg of simvastatin therapy is associated with a significantly increased coenzyme Q10/LDL-cholesterol ratio and vitamin E/LDL-cholesterol ratio. Simvastatin treatment is not associated with impairment in left ventricular systolic or diastolic function in hypercholesterolaemic subjects after 6 months of treatment.
authors.affiliation: Greenslopes Private Hospital and The Wesley Hospital, Brisbane, Australia. d.colquhoun@uq.edu.au
authors.forename: D M
authors.initials: DM
authors.lastname: Colquhoun
authors.forename: R
authors.initials: R
authors.lastname: Jackson
authors.forename: M
authors.initials: M
authors.lastname: Walters
authors.forename: B J
authors.initials: BJ
authors.lastname: Hicks
authors.forename: J
authors.initials: J
authors.lastname: Goldsmith
authors.forename: P
authors.initials: P
authors.lastname: Young
authors.forename: C
authors.initials: C
authors.lastname: Strakosch
authors.forename: K M
authors.initials: KM
authors.lastname: Kostner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000032:analysis; D001053:Apolipoproteins / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003067:Coenzymes; D004452:Echocardiography; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000627:therapeutic use*; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood*; D016277:Ventricular Function, Left / Q000187:drug effects*; D014810:Vitamin E / Q000097:blood*
chemical_list: D000924:Anticholesteremic Agents; D000975:Antioxidants; D001053:Apolipoproteins; D008078:Cholesterol, LDL; D003067:Coenzymes; D008055:Lipids; D014451:Ubiquinone; D014810:Vitamin E; D019821:Simvastatin; C024989:coenzyme Q10