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Combined hyperlipidemia in a single subject with tetraplegia: ineffective risk reduction after atorvastatin
Mark S Nash1, Brad M Johnson, Patrick L Jacobs
1Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA. msnash@miami.edu
Insights
Atorvastatin therapy lowered cholesterol and triglycerides in a patient with tetraplegia. However, cardiovascular disease risk ratios remained unchanged due to a significant drop in HDL cholesterol.
Area of Science:
- Cardiology
- Pharmacology
- Neuroscience
Background:
- Cardiovascular disease (CVD) risk assessment is crucial, especially in individuals with neurological conditions like tetraplegia.
- Lipid profiles, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C), are key indicators of CVD risk.
Observation:
- This study examined the effects of atorvastatin (Lipitor) monotherapy (10 mg daily) on a single patient with C5-C6 tetraplegia.
- Lipid profiles were measured before and after three months of atorvastatin treatment.
Findings:
- Atorvastatin significantly reduced fasting TC, TG, and LDL-C levels.
- However, HDL-C levels decreased from 35 mg/dL to 21 mg/dL.
- Consequently, the TC:HDL risk ratio showed minimal reduction (6.6 to 6.4), and the LDL:HDL risk ratio remained unchanged.
Implications:
- While atorvastatin effectively lowers key lipid components, its impact on CVD risk prediction ratios may be complex in patients with tetraplegia.
- The significant reduction in HDL-C warrants further investigation regarding its long-term implications for cardiovascular health in this population.
Background/Objective:
Effects of atorvastatin (Lipitor) drug monotherapy (10 mg daily) on fasting blood lipid profiles and cardiovascular disease (CVD) risks were examined for a single subject with C5-C6 tetraplegia. Routine fasting lipid profiles were analyzed by standard biochemistry techniques for total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Lipid profiles were analyzed on 3 occasions before drug therapy was initiated and 3 months after therapy commenced. The TC:HDL and LDL:HDL ratios were computed for all sampling times and used to assess pretreatment and post-treatment CVD risk.
Results:
Fasting TC, TG, and LDL-C were all significantly reduced by therapy. The pretreatment HDL-C of 35 mg/dL was lowered to 21 mg/dL. As a result, the TC:HDL risk ratio was only marginally reduced from 6.6 to 6.4, whereas the LDL:HDL risk ratio remained unchanged by treatment.
Conclusions:
In this man with tetraplegia, atorvastatin drug monotherapy rapidly lowered TC, TG, LDL-C, and HDL-C. However, the TC:HDL ratio, considered the best predictor of CVD risk, was unchanged.
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