One-year atorvastatin treatment in hypercholesterolemic patients with or without carotid artery disease

Aim. Statins are the drugs of choice in heterozygous familial hypercholesterolemia (FH), which has a high risk of premature cardiovascular events including myocardial infarction, stroke, and surgical revascularization. Methods. A 1-year open-label study was conducted to test the efficacy and tolerability of Atorvastatin titrated to the target, in proven FH patients and to evaluate certain inflammatory parameters. One hundred and two FH patients (44 men and 58 women; mean age 58.7±3.6 years) were included in the study. After evaluation using the B-mode duplex scanning system of extracranial carotid arteries, the patients were divided into groups: Group 1 (15 men, 25 women) with carotid plaques or intima-media thickness (IMT) greater than 0.95 mm and Group 2 (30 men, 32 women) without carotid plaques or IMT less than 0.95 mm. After a 6-week hypolipemic diet phase all the patients were treated with atorvastatin titrated to achieve a low density lipoprotein (LDL-C) <100 mg/dL. Patients with carotid lesions were also submitted to an oral fixed dose of aspirin 100 mg/day. Results. In patients without and with carotid lesions, atorvastatin treatment (mean dosage: 23.5 mg/day) reduced triglycerides by 8.7% (P<0.005) and 10.6% (P<0.005), total cholesterol by 41.5% (P<0.005) and 42.6% (P<0.005), LDL-C by 55.8% (P<0.005) and 57.3% (P<0.005) and apolipoprotein B by 38.3% (P<0.005) and 37.2% (P<0.005) respectively, and increased the mean levels of high density lipoprotein cholesterol (HDL-C) by 8.7% (P<0.005) and 11% (P<0.005), and apolipoprotein A-I by 3.2% (P<0.05) and 3.3%, respectively. In both groups of patients the mean decrease (52 weeks) of fibrinogen was 19.8% (P<0.005) and 10.4% (P<0.005), respectively and of high sensitivity C-reactive protein (hs-CRP), 36.2% (P<0.005) and 38.2% (P<0.005), respectively. No variation of the parameters of safety and clinical tolerability of the drugs administered was observed. No variation in hematocrit in the patients taking ASA treatment was observed. Conclusion. In FH patients, 1-year atorvastatin treatment titrated to the target (LDL-C <100 mg/dL) was well tolerated and improved serum lipid levels and inflammatory parameters

Effetto di due vini rossi siciliani su alcuni fattori di rischio cardiovascolare

Background. The aim of this study was to evaluate whether Sicilian red wine consumption is associated with a lower cardiovascular risk. Methods. Forty-eight subjects of both sexes (age range 35-65 years) nondrinkers or rarely drinkers of moderate red wine intake were selected. Subjects were divided into two groups (group A and group B), assigned to receive with a crossover design 250 ml/die (during the meals) of one of two types of Sicilian red wines (Nero d’Avola and Etna Torrepalino respectively). At all visits (-15 days, basal, +4 and +8 weeks) the following parameters were measured: blood glucose, total cholesterol and triglycerides (by enzyme kit methods, Boehringer Mannheim, Milan, Italy), HDL cholesterol (by selective precipitation with dextran-magnesium chloride), LDL cholesterol (by calculation with the Friedewald formula), LDL/HDL ratio, apolipoproteins A1 and B (by radial immunodiffusion, Behring Institute, Scoppito, Italy), lipoprotein(a) (ELISA, Technoclone, Vienna, Austria), plasma C-reactive protein (high-sensitivity, Dade Behring, Marburg, Germany), D-dimer (Turbiquant, Dade Behring), factor VII (coagulant activity, Dade Behring), plasminogen activator inhibitor antigen (ELISA), tissue-type plasminogen activator antigen (ELISA), fibrinogen (coagulant), oxidized LDL antibody (ELISA), total plasma antioxidant capacity (FRAP method). Results. At the end of the red wine intake period, HDL cholesterol was significantly increased (p< 0.01) and the LDL/HDL ratio was significantly decreased (p < 0.05) in both study groups, while apolipoprotein A1 was significantly increased (p < 0.05) only in group A. In both group A and group B fibrinogen (p < 0.01 and p < 0.005, respectively), factor VII (p < 0.01 and p < 0.05, respectively), plasma C-reactive protein (p < 0.005 and p < 0.05, respectively) and oxidized LDL antibody (p < 0.05) were significantly decreased, while tissue-type plasminogen activator (p < 0.005), plasminogen activator inhibitor (p < 0.005) and total plasma antioxidant capacity (p < 0.005) were significantly increased. Conclusions. Our results show a positive effect of these Sicilian red wines on many risk factors, suggesting a moderate consumption of red wine in the adult population as a component of the Mediterranean diet