title: Effects of Rosuvastatin Versus Atorvastatin, Alone or in Combination, on Lipoprotein (a).
abstract: There are little evidences about the therapeutic efficacy of different lipid-lowering agents in the reduction of elevated lipoprotein(a) [Lp(a)].
  
  
  
  testing the effect of different lipid-lowering agents on elevated Lp(a).
  
  
  
  prospective interventional study performed in patients with CAD, or high CAD risk, with Lp(a), >50 mg/dL. Lp(a), total cholesterol (C), HDL-C, LDL-C, triglycerides (TGs), apolipoprotein (Apo) A1, Apo B, enzymes of myocyte and hepatic injury were comparatively analyzed between 4 lipid-lowering strategies: rosuvastatin (R group) 40 mg, atorvastatin (A group) 80 mg, atorvastatin 40 mg add-on micronized fenofibrate (A+F group), and atorvastatin 40 mg add-on 1 g extended-release niacin (A+ERN group). Comparison was made for their therapeutic efficacy on Lp(a), and safety.
  
  
  
  87 patients with mean Lp(a) 94.6 ± 39.6 mg/dL were analyzed. Groups: 25 patients in the R, 22 in the A, 20 in the A+F and 20 in A+ERN group. Significant reduction in all lipid fractions in all treatment groups was reported after 6 months. The average reduction of Lp(a) was 15.9 ± 21.0 mg/dL, with: 18.2 ± 24.8 (P = 0.001) in the R group, 17.3 ± 10.4 (P = 0.001) in A+F, 19.5 ± 10.9 (P = 0.001) in A+ERN and the lowest in the A group (11.24 ± 22.91, P = 0.032). No adverse effects were observed in any of the treatment groups.
  
  
  
  When compared with atorvastatin, it seems that rosuvastatin can achieve more significant decrease of Lp(a).The efficacy of the second one can be increased by adding fibrate or ERN.
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia marija.vavlukis@gmail.com.
authors.forename: Marija
authors.initials: M
authors.lastname: Vavlukis
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Mladenovska
authors.affiliation: Hasan Prishtina University, Prishtina, Republic of Kosovo.
authors.forename: Arlinda
authors.initials: A
authors.lastname: Daka
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Dimovski
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia.
authors.forename: Saska
authors.initials: S
authors.lastname: Domazetovska
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Kuzmanovska
authors.affiliation: Ss Cyril and Methodius University, Skopje, Republic of Macedonia.
authors.forename: Sasko
authors.initials: S
authors.lastname: Kedev
mesh_terms: D016632:Apolipoprotein A-I / Q000097:blood; D000069059:Atorvastatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D000068718:Rosuvastatin Calcium / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D000960:Hypolipidemic Agents; D017270:Lipoprotein(a); D014280:Triglycerides; D009525:Niacin; D000068718:Rosuvastatin Calcium; D002784:Cholesterol; D000069059:Atorvastatin; D011345:Fenofibrate
keywords: dyslipidemia; extended-release niacin (ERN); lipoprotein (a); micronized fenofibrate; statins