title: Effect of statins on LDL particle size in patients with familial combined hyperlipidemia: a comparison between atorvastatin and pravastatin.
abstract: OBJECTIVE
  Elevation of plasma cholesterol and/or triglycerides, and the prevalence of small dense low density lipoproteins (LDL) particles remarkably increase the risk in patients with familial combined hyperlipidemia (FCHL). There are, at present, inconsistent data on the effects of different treatments on size and density of LDL particles in FCHL patients.
  
  
  RESULTS
  A multicenter, randomized, double-blind, double-dummy, parallel group study was designed to evaluate the effect of 3 months' treatment with atorvastatin (10mg/day) or pravastatin (20mg/day) on the lipid/lipoprotein profile and LDL size in a total of 86 FCHL patients. Both statins significantly lowered plasma total and LDL cholesterol, with a significantly higher hypocholesterolemic effect observed with atorvastatin (-26.8+/-11.1% and -35.9+/-11.1%, respectively) compared to pravastatin (-17.6+/-11.1% and -24.5+/-10.2%). The percent decrease in plasma triglycerides was highly variable, but more pronounced with atorvastatin (-19.8+/-29.2%) than with pravastatin (-5.3+/-48.6%). Opposite changes in LDL size were seen with the 2 treatments, with increased mean LDL particle diameter with atorvastatin, and decreased diameter with pravastatin, and significant between treatment difference in terms of percent modification vs baseline (+0.5+/-1.6% with atorvastatin vs -0.3+/-1.8% with pravastatin).
  
  
  CONCLUSIONS
  The present results support the evidence indicative of a greater hypocholesterolemic effect of atorvastatin compared to pravastatin, and in addition show a raising effect of atorvastatin on the size of LDL particles in FCHL patients.
authors.affiliation: Center E. Grossi Paoletti, Department of Pharmacological Sciences, University of Milano, Via Balzaretti 9, 20133 Milano, Italy. cesare.sirtori@unimi.it
authors.forename: Cesare R
authors.initials: CR
authors.lastname: Sirtori
authors.forename: Laura
authors.initials: L
authors.lastname: Calabresi
authors.forename: Livia
authors.initials: L
authors.lastname: Pisciotta
authors.forename: Luigi
authors.initials: L
authors.lastname: Cattin
authors.forename: Paolo
authors.initials: P
authors.lastname: Pauciullo
authors.forename: Mario
authors.initials: M
authors.lastname: Montagnani
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bittolo Bon
authors.forename: Renato
authors.initials: R
authors.lastname: Fellin
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D017035:Pravastatin / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D014280:Triglycerides; D000069059:Atorvastatin; D017035:Pravastatin