title: L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study.
abstract: Lipoprotein (a) [Lp(a)] is an independent risk factor for cardiovascular disease. There are currently limited therapeutic options to lower Lp(a) levels. L-Carnitine has been reported to reduce Lp(a) levels. The aim of this study was to compare the effect of L-carnitine/simvastatin co-administration with that of simvastatin monotherapy on Lp(a) levels in subjects with mixed hyperlipidemia and elevated Lp(a) concentration. Subjects with levels of low-density lipoprotein cholesterol (LDL-C) >160 mg/dL, triacylglycerol (TAG) >150 mg/dL and Lp(a) >20 mg/dL were included in this study. Subjects were randomly allocated to receive L-carnitine 2 g/day plus simvastatin 20 mg/day (N = 29) or placebo plus simvastatin 20 mg/day (N = 29) for a total of 12 weeks. Lp(a) was significantly reduced in the L-carnitine/simvastatin group [-19.4%, from 52 (20-171) to 42 (15-102) mg/dL; p = 0.01], but not in the placebo/simvastatin group [-6.7%, from 56 (26-108) to 52 (27-93) mg/dL, p = NS versus baseline and p = 0.016 for the comparison between groups]. Similar significant reductions in total cholesterol, LDL-C, apolipoprotein (apo) B and TAG were observed in both groups. Co-administration of L-carnitine with simvastatin was associated with a significant, albeit modest, reduction in Lp(a) compared with simvastatin monotherapy in subjects with mixed hyperlipidemia and elevated baseline Lp(a) levels.
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Florentin
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece. egepi@cc.uoi.gr.
authors.forename: M S
authors.initials: MS
authors.lastname: Elisaf
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
authors.forename: C V
authors.initials: CV
authors.lastname: Rizos
authors.affiliation: Department of Cardiology, "Korgialenio Benakio-HRC" Hospital, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Nikolaou
authors.affiliation: Lipid Outpatient Clinic, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Bilianou
authors.affiliation: First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Pitsavos
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
authors.forename: E N
authors.initials: EN
authors.lastname: Liberopoulos
mesh_terms: D000328:Adult; D053299:Apolipoprotein B-100 / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000517:prevention & control*; D002331:Carnitine / Q000008:administration & dosage* / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006954:Hyperlipoproteinemia Type V / Q000188:drug therapy* / Q000378:metabolism; D017270:Lipoprotein(a) / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019821:Simvastatin / Q000008:administration & dosage* / Q000494:pharmacology; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D055815:Young Adult
chemical_list: C569471:APOB protein, human; D053299:Apolipoprotein B-100; D017270:Lipoprotein(a); D014280:Triglycerides; D002784:Cholesterol; D019821:Simvastatin; D002331:Carnitine
keywords: L-Carnitine; Lipoprotein (a); Simvastatin; Triglycerides