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Fibrinogen response with simvastatin versus atorvastatin in familial hypercholesterolemia
A S Wierzbicki1, P J Lumb, G Chik
1Department of Chemical Pathology, King's College London, Guy's, King's & St. Thomas' Medical School, United Kingdom. Wierzbicki@kcl.ac.uk
Insights
Atorvastatin therapy, baseline fibrinogen, and initial lipid levels influence fibrinogen response in hypercholesterolemia patients. Understanding these factors is key for effective cholesterol management.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- Hypercholesterolemia is a significant risk factor for cardiovascular disease.
- Fibrinogen is an independent risk factor for atherosclerosis and thrombosis.
- Statins are widely used to manage hypercholesterolemia, but their effects on fibrinogen can vary.
Purpose of the Study:
- To investigate the clinical and biochemical factors determining the fibrinogen response to simvastatin and atorvastatin.
- To identify predictors of hyperfibrinogenemia in patients with severe hypercholesterolemia.
Main Methods:
- A randomized open-trial design was used.
- 130 patients with severe polygenic or familial hypercholesterolemia were enrolled.
- Fibrinogen levels were measured alongside clinical and biochemical parameters, including lipid profiles and apolipoprotein B.
Main Results:
- Hyperfibrinogenemia was associated with atorvastatin treatment.
- Baseline fibrinogen levels predicted the response.
- Initial concentrations and changes in apolipoprotein B and low-density lipoprotein cholesterol were also associated with fibrinogen levels.
Conclusions:
- Atorvastatin, baseline fibrinogen, and lipid parameters (apolipoprotein B, LDL cholesterol) are key determinants of the fibrinogen response.
- These findings aid in personalizing statin therapy for hypercholesterolemia patients.
- Further research may elucidate mechanisms linking statins, lipids, and fibrinogen.
Abstract:
The clinical and biochemical determinants of the fibrinogen response to simvastatin or atorvastatin therapy were assessed in 130 patients with severe polygenic or familial hypercholesterolemia treated in a randomized open-trial format design. Hyperfibrinogenemia was associated with atorvastatin, baseline fibrinogen, and initial concentration and change in concentration of apolipoprotein B or low-density lipoprotein cholesterol.