RESUMO
PURPOSE: To evaluate lipid profile changes associated with cholestyramine addition in hypercholesterolemic patients with established coronary heart disease under treatment with HMG-CoA reductase inhibitors that had not achieved the ideal value of LDL-cholesterol. METHODS: Twenty patients with coronary heart disease, (12 submitted to coronary artery bypass grafts, 3 to coronary angioplasty and 5 maintained under clinical management) with mean age of 60.78 years old, who were under hypolipemic diet and were medicated with lovastatin 20 mg/d or simvastatin 10 mg/d, received cholestyramine, doses ranging from 8 to 16 g/day during 8 weeks, aiming to reduce LDL-cholesterol to values less than 100 mg/dL. RESULTS: There was a significant reduction of total cholesterol, from initial mean value of 239.52 mg/dL to final mean value of 199.00 mg/dL, with a mean reduction of 16.92%. The mean value of LDL-cholesterol was also reduced significantly from 172.73 mg/dL to 118.26 mg/dL, with a mean reduction of 31.53%. Mean triglyceridemia increased, still within the normal reference values, from 145.05 mg/dL to 162.00 mg/dL, and the mean difference was 11.69%. There was a significant increase of HDL-cholesterol fraction from an initial mean value of 38.00 mg/dL to a final mean value of 48.21 mg/dL, mean difference of 26.87%. Side effects were not frequent, and did not interfere in the duration of the study. CONCLUSION: The association of cholestyramine to HMG-CoA reductase inhibitors, both in low doses, in patients with primary hypercholesterolemia and high coronary risk is a good therapeutic option that can reach benefits on the lipid profile similar to those obtained when these drugs are used in association or separately in higher doses.
Assuntos
Anticolesterolemiantes/uso terapêutico , Resina de Colestiramina/uso terapêutico , Doença das Coronárias/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , LDL-Colesterol/análise , Resina de Colestiramina/efeitos adversos , Combinação de Medicamentos , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To evaluate the clinical efficacy of etofibrate in primary hyperlipidemia in patients from clinical centers representative of all main Brazilian cities. METHODS: One thousand, nine hundred and fourty three hyperlipidemic patients were submitted to diet and drug treatment with etofibrate (500 mg/day) for eight weeks. The data b WAS analyzed as to changes in the lipoprotein profile, as well as the side effects. RESULTS: There was an important reduction in total cholesterol (19.88%), triglycerides (29.59%), LDL-c (14.89%) and VLDL-c (14.54%) concentration. There was a significant increase in HDL-c (18.14%). Adverse effects were observed in 8.5% of the patients, without major clinical relevance, however, in 1.44% the treatment had to be interrupted. CONCLUSION: Administration of etofibrate promoted positive changes in all parameters of the lipid and lipoprotein profile, thus reducing the risk of atherosclerotic disease, without significant side effects in the great majority of sample studied.
Assuntos
Ácido Clofíbrico/análogos & derivados , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Colesterol/sangue , Ácido Clofíbrico/uso terapêutico , Feminino , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/dietoterapia , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangueRESUMO
PURPOSE: To evaluate modifications on lipid profile, fibrinogen and platelet aggregation induced by etofibrate. METHODS: Twenty-one adult patients were studied. They all had primary hyperlipidemia and had already been on the AHA step I diet and placebo. Etofibrate (500mg/day) was administered for 60 days in the active phase, when lipid parameters, fibrinogen and platelet aggregation were measured. RESULTS: The % significant reductions were: total cholesterol (-9.50%), LDL-cholesterol (-7.88%), triglycerides (-19.07%), total cholesterol/HDL-cholesterol(-11.90%), LDL-cholesterol/HDL-cholesterol (-10.20%), fibrinogen (-12.79%), platelet aggregation with adrenaline (-24.02%), with ADP 1 mumol (-30.13%), and ADP 3 mumol (-24.51%). CONCLUSION: The beneficial effects of etofibrate were observed not only on the lipid profile but also on the thrombogenic parameters measured by fibrinogen and platelet aggregation.
Assuntos
Fibrinogênio/efeitos dos fármacos , Hipolipemiantes/farmacologia , Lipídeos/sangue , Agregação Plaquetária/efeitos dos fármacos , Adulto , Ácido Clofíbrico/administração & dosagem , Ácido Clofíbrico/análogos & derivados , Ácido Clofíbrico/farmacologia , Feminino , Fibrinogênio/análise , Humanos , Hipolipemiantes/administração & dosagem , Lipoproteínas/sangue , MasculinoRESUMO
Objetivo - avaliar os efeitos do etofibrato sobre variáveis lipídicas, fibrinogênio e agregaçäo plaquetária. Métodos - foram selecionados 21 portadores de hiperlipidemia primária, associada a fatores de risco para doença coronária, após introduçäo de dieta (AHA fase I) e dias, analisando-se as modificaçöes lipídicas induzidas (colesterol total e fraçöes, triglicérides) e efeitos sobre o fibrinogênio e agregaçäo plaquetária. Resultados - foram observadas reduçöes percentuais significantes das variávs: colesterol total (9,50 por cento), LDL-colesterol (-7,88 por cento), triglicérides (19,07 por cento), colesterol total/HDL-colesterol (-11,90 por cento), LDL-colesterol/HDL-colesterol (-19,20 por cento), fibrinogênio (-12, 79 por cento) agregaçäo plaquetária com adrenalina (-24,02 por cento), com ADP 1 ymol (-30,13 por cento), com ADP 3 ymol (-24,51 por cento). Conclusäo - efietos benéficos do etofibrato foram observados näo somente sobre o perfil lipídico mas, também sobre variáveis de trobogenicidae como o fibrinogênio e a agregaçäo plaquetária.
Assuntos
Colesterol , Agregação Plaquetária , FibrinogênioRESUMO
PURPOSE: To evaluate the effects of pravastatin on lipoproteins, Lp (a), apo B and apo A-I and its tolerability in primary hypercholesterolemic patients in our outpatient lipid clinic. METHODS: Twenty-two primary hypercholesterolemic patients were evaluated. They had all been treated previously with other hypocholesterolemic drugs, including the statins, forming a specific and homogeneous group with hypercholesterolemia and definite coronary risk. After 7 weeks with American Heart Association phase I diet and placebo drug, pravastatin was administered during 12 weeks. All patients received an initial daily dose of 10 mg for six weeks. After this period, this dose was increased to 20 mg. The levels of cholesterol, triglycerides, high-density lipoprotein, lipoprotein (a) and apolipoproteins A-1 and B were determined. RESULTS: No changes occurred with diet and placebo, but pravastatin at a daily dose of 10 mg, reduced significantly cholesterol level (7.22%), LDL-cholesterol (13.08%) and increased HDL-cholesterol (7.81%). The results were better with 20 mg, achieving a reduction of (28.21%) in cholesterol, (36.88%) in LDL-cholesterol, (17.06%) in apo B level and an increase of (10.06%) in HDL-cholesterol. The smaller effect observed with the more commonly used dosage (10 mg/day) was most probably due to the characteristics of the sample with already established hypercholesterolemia, being thus dependent of higher concentrations of medications, as observed in previous treatments in our outpatient clinic. Side affects with this drug were rare. No biochemical changes were observed that would interrupt the continuation of therapy. CONCLUSION: Pravastatin was well tolerated and promoted favorable changes in the total cholesterol, LDL, apo B and cholesterol/HDL and LDL/HDL ratios of primary hypercholesterolemic patients.