The effect of rosuvastatin alone or in combination with fenofibrate or omega-3 fatty acids on lipoprotein(a) levels...

Area of Science:

• Cardiology
• Lipidology
• Pharmacology

Background:

• Lipoprotein(a) [Lp(a)] is a key genetic risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Mixed hyperlipidemia requires effective management to mitigate cardiovascular risk.

Purpose of the Study:

• To investigate the impact of different hypolipidemic treatments on Lp(a) levels in patients with mixed hyperlipidemia.
• To compare the effects of rosuvastatin monotherapy, rosuvastatin-fenofibrate combination, and rosuvastatin-omega-3 fatty acids combination on Lp(a) levels.

Main Methods:

• A post-hoc analysis of a randomized trial involving patients with mixed hyperlipidemia (LDL-C > 160 mg/dl, triglycerides > 200 mg/dl).
• Patients received rosuvastatin monotherapy (R), rosuvastatin plus fenofibrate (RF), or rosuvastatin plus omega-3 fatty acids (RΩ).
• Lp(a), lipid profiles, and non-high-density lipoprotein-cholesterol (non-HDL-C) were measured at baseline and after 3 months.

Main Results:

• All treatment groups showed significant reductions in total cholesterol, LDL-C, non-HDL-C, and triglycerides.
• A significant increase in Lp(a) levels was observed in the rosuvastatin (R) and rosuvastatin-fenofibrate (RF) groups (p < 0.05).
• No significant change in Lp(a) levels was noted in the rosuvastatin-omega-3 fatty acids (RΩ) group (p = NS).
• Strong negative correlations were found between changes in Lp(a) and LDL-C in the R group (r = -0.500, p = 0.049) and between Lp(a) and triglycerides in the RF group (r = -0.531, p = 0.034).

Conclusions:

• Rosuvastatin and fenofibrate treatments can elevate Lp(a) levels in patients with mixed hyperlipidemia.
• Omega-3 fatty acids, in combination with rosuvastatin, did not significantly alter Lp(a) levels.
• Future therapies should aim to reduce Lp(a) to address residual ASCVD risk in this patient population.