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Short-term effect of atorvastatin in hypercholesterolaemic renal-transplant patients unresponsive to other statins
R Romero1, J Calviño, J Rodriguez
1Division of Nephrology, Department of Medicine, Hospital Clínico Universitario, Santiago de Compostela, Spain.
Insights
Atorvastatin effectively lowered atherogenic lipids like cholesterol in renal transplant patients who did not respond to other statins. This HMG-CoA reductase inhibitor showed a good safety profile in this patient group.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Hyperlipidemia is a significant risk factor for cardiovascular disease and mortality post-renal transplantation.
- Statins are commonly used to manage hyperlipidemia, but some renal transplant patients exhibit limited response.
- Atorvastatin, a potent HMG-CoA reductase inhibitor, offers a favorable lipid-lowering profile.
Purpose of the Study:
- To evaluate the efficacy and safety of atorvastatin in hypercholesterolemic renal transplant recipients.
- To assess atorvastatin's effectiveness in patients with a history of poor response to other statins.
Main Methods:
- A cohort of 10 renal transplant recipients with persistent hypercholesterolemia (total cholesterol >240 mg/dl) received atorvastatin 10 mg/day for 3 months.
- All participants had previously used statins for at least 3 months with minimal or no lipid-lowering effect.
Main Results:
- Atorvastatin achieved significant reductions in total cholesterol (311±36.2 to 253±48.8 mg/dl) and LDL cholesterol (184±30.9 to 136±22.9 mg/dl) (P<0.05).
- In patients with elevated baseline triglycerides (>150 mg/dl), atorvastatin markedly reduced triglyceride levels (261±80.3 to 193±53.3 mg/dl) (P<0.05).
- No significant changes were observed in HDL cholesterol, Lp(a), serum creatinine, transaminases, creatinine phosphokinase, or cyclosporin A levels. The drug was well-tolerated without reported myositis or rhabdomyolysis.
Conclusions:
- Short-term atorvastatin therapy is effective in reducing atherogenic lipids in renal transplant patients.
- Atorvastatin presents a viable treatment option for hypercholesterolemia in renal transplant recipients with prior statin non-response.
- The safety profile of atorvastatin in this population appears favorable.
Background:
Atherosclerosis associated with hyperlipidaemia is a major cause of morbidity and mortality after renal transplantation. Atorvastatin is a new HMG-CoA reductase inhibitor that has shown a favourable profile of lipid reduction when compared with other statins. The aim of the study was to assess the efficacy and safety of atorvastatin in hypercholesterolaemic renal transplant patients who had previously been on statins with little or no effect.
Methods:
Atorvastatin, 10 mg/day, was administered to 10 renal transplant recipients with persistent hypercholesterolaemia (total cholesterol >240 mg/dl) for a period of 3 months. All of them had already been on statins for at least 3 months.
Results:
Atorvastatin exerted a satisfactory lipid-lowering effect in seven of 10 patients. On average, serum total cholesterol (311+/-36.2 vs 253+/-48.8 mg/dl; P:<0.05) and serum LDL cholesterol (184+/-30.9 vs 136+/-22.9 mg/dl; P:<0.05) significantly decreased after atorvastatin therapy, whereas serum HDL cholesterol (86+/-14.6 vs 84+/-22.1 mg/dl) remained unchanged. In five subjects with a baseline serum triglyceride level above 150 mg/dl, a marked reduction in triglycerides was also observed (261+/-80.3 vs 193+/-53.3 mg/dl; P:<0.05). Lp(a) did not significantly change (13+/-16.3 vs 15+/-23.9 mg/dl, P:=NS). Serum creatinine, transaminases, creatinine phosphokinase (55+/-21.3 vs 56+/-29.4 IU/l) and fasting cyclosporin A levels were unaffected. The drug was generally well tolerated and neither myositis nor rhabdomyolysis was reported.
Conclusion:
Short-term therapy with the new HMG-CoA reductase inhibitor, atorvastatin, appears to be effective in lowering atherogenic lipids in renal transplant patients who had had little or no response to other statins.