Main differences between two highly effective lipid-lowering therapies in subclasses of lipoproteins in patients with acute myocardial infarction

Author(s):Show less -

Pinto, Leticia C. S. ^[1] ; Mello, Ana P. Q. ^[1] ; Izar, Maria C. O. ^[1] ; Damasceno, Nagila R. T. ^[2] ; Neto, Antonio M. F. ^[3] ; Franca, Carolina N. ^[4] ; Caixeta, Adriano ^[1] ; Bianco, Henrique T. ^[1] ; Povoa, Rui M. S. ^[1] ; Moreira, Flavio T. ^[1] ; Bacchin, Amanda S. F. ^[1] ; Fonseca, Francisco A. ^[1]

Affiliation

^[1] Univ Fed Sao Paulo, UNIFESP, Escola Paulista Med, Setor Lipides Aterosclerose & Biol Vasc, Rua Loefgren 1350, BR-04040001 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Saude Publ, USP, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Inst Fis, USP, Sao Paulo - Brazil

^[4] Univ Santo Amaro, UNISA, Sao Paulo - Brazil

• Document type: Journal article
• Source: LIPIDS IN HEALTH AND DISEASE; v. 20, n. 1 SEP 29 2021.
• Web of Science Citations: 0

Abstract

Background: Large observational studies have shown that small, dense LDL subfractions are related to atherosclerotic cardiovascular disease. This study assessed the effects of two highly effective lipid-lowering therapies in the atherogenic subclasses of lipoproteins in subjects with ST-segment elevation myocardial infarction (STEMI). Methods: Patients of both sexes admitted with their first myocardial infarction and submitted to pharmacoinvasive strategy (N = 101) were included and randomized using a central computerized system to receive a daily dose of simvastatin 40 mg plus ezetimibe 10 mg or rosuvastatin 20 mg for 30 days. Intermediate-density lipoprotein (IDL) and low-density lipoprotein (LDL) subfractions were analysed by polyacrylamide gel electrophoresis (Lipoprint System) on the first (D1) and 30th days (D30) of lipid-lowering therapy. Changes in LDL and IDL subfractions between D1 and D30 were compared between the lipid-lowering therapies (Mann-Whitney U test). Results: The classic lipid profile was similar in both therapy arms at D1 and D30. At D30, the achievement of lipid goals was comparable between lipid-lowering therapies. Cholesterol content in atherogenic subclasses of LDL (p = 0.043) and IDL (p = 0.047) decreased more efficiently with simvastatin plus ezetimibe than with rosuvastatin. Conclusions: Lipid-lowering therapy with simvastatin plus ezetimibe was associated with a better pattern of lipoprotein subfractions than rosuvastatin monotherapy. This finding was noted despite similar effects in the classic lipid profile and may contribute to residual cardiovascular risk. (AU)

• FAPESP's process: 12/51692-7 - Role of adaptative immunity on the progress of ischemic heart disease after acute myocardial infarction
• Grantee: Francisco Antonio Helfenstein Fonseca
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 14/50983-3 - INCT 2014: complex fluids
• Grantee: Antonio Martins Figueiredo Neto
• Support Opportunities: Research Projects - Thematic Grants