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Objetivos
Evaluar el efecto del etofibrato de liberación sostenida en las concentraciones de lipoproteína(a) [Lp(a)] plasmática en pacientes con concentraciones superiores a 300 mg/l después de 3 meses de dieta tipo etapa I del National Colesterol Education Program (NCEP)
MétodoDe un total de 112 pacientes examinados en la consulta externa de dislipidemias del Hospital Hermanos Ameijeiras, La Habana, se seleccionó a 20 pacientes (10 varones y 10 mujeres) que presentaron concentraciones séricas de Lp(a) superiores a 300 mg/l después de 3 meses de dieta hipolipemiante etapa I del NCEP. Se administró a los pacientes seleccionados etofibrato, 500 mg/día, durante 24 semanas. Se determinaron las concentraciones de colesterol y triglicéridos totales, de colesterol asociado a las lipoproteínas de baja (cLDL) y alta (cHDL) densidad y las de Lp(a) antes y a las 4, 12 y 24 semanas del tratamiento
ResultadosSe observaron reducciones significativas de colesterol, triglicéridos y cLDL y aumentos de cHDL en cada tiempo analizado en relación con el valor basal. Las concentraciones séricas de Lp(a) se redujeron significativamente (p < 0,01) con la administración de etofibrato: 856 mg/l en situación basal, 617 mg/dl a la cuarta semana después del tratamiento, 594 mg/l a la 12.a semana y 604 mg/l a la 24.a semana. La reducción ya fue significativa desde la cuarta semana de tratamiento y se mantuvo así hasta la 24.a semana. En 4 de los 20 pacientes, cuyas concentraciones basales de Lp(a) fueron las más bajas de todo el grupo, se observó un aumento significativo (p < 0,001) de la Lp(a) en la semana 24 de tratamiento (desde 559 a 636 mg/l)
ConclusionesEl etofibrato de liberación retardada, a dosis de 500 mg/día, redujo las concentraciones de Lp(a) en más del 30%, en relación a su valor basal, después de 4 semanas de su administración y mantuvo esta tendencia durante las 24 semanas de control en los pacientes con las concentraciones más elevadas; en los pacientes con concentraciones más bajas (aunque superiores a 300 mg/l) se incrementó ligera, pero significativamente la Lp(a). Estos efectos del etofibrato en la concentración de Lp(a) no han sido descritos con anterioridad
Palabras clave:
Lipoproteína(a)
Etofibrato
Objectives
To evaluate the effect of a sustainedrelease form of etofibrate on the lipoprotein(a) [Lp(a)] concentration in patients showing Lp(a) concentrations higher than 300 mg/l after a 3- month period of NCEP National Cholesterol Education Program (NCEP) step-I diet
MethodsAmong 112-screened patients, 20 (10 female and 10 male) were selected when their Lp(a) concentrations were higher than 300 mg/l after 3-month period on NCEP step type-I diet. All selected patients received etofibrate retard (500 mg/day) during 24 weeks. Total cholesterol and triglycerides and cholesterol associated to low (LDLc) and high density (HDLc) lipoproteins, as well as Lp(a) concentrations were measured before and after 4, 12 and 24 weeks of etofibrate therapy
ResultsSignificant decrease respect to pretreatment values was observed for total cholesterol and triglyceride and for low (LDLc) and high (HDLc) cholesterol concentrations after etofibrate therapy. Lp(a) concentrations decreased significantly (p < 0.01) from 856 to 617 mg/l (after 4 weeks of etofibrate), 594 (after 12 weeks) and 604 (after 24 weeks). Significant reductions of Lp(a) occurred since week 4 of therapy. Four of the 20 treated patients, showed small, but significant (p < 0.001) increases (from 559 to 636 mg/l) of Lp(a) concentrations after etofibrate therapy; Lp(a) concentrations of these patients were the smallest among all the analyzed patients
ConclusionsExtended-release etofibrate at a dose of 500 mg/day reduced Lp(a) concentrations in a 30% after 4-weeks of therapy; the effect of etofibrate on Lp(a) concentrations extended until the end of therapy (at 24th week of treatment). Etofibrate reduced Lp(a) concentrations in patients showing higher Lp(a) concentrations; however, in patients showing smallest increases of Lp(a) a light, but significant, increase of Lp(a) was observed. These effects of etofibrate on Lp(a) concentrations are described for the first time
Key words:
Lipoprotein(a)
Etofibrate
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