Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL
The HDL Atherosclerosis Treatment Study (HATS) demonstrated a clinical benefit in coronary artery disease patients with low HDL cholesterol (HDL-C) levels treated with simvastatin and niacin (S-N) or S-N plus antioxidants (S-N+A) compared with antioxidants alone or placebo. Angiographically document...
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| Format: | Article |
| Language: | English |
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Elsevier
2003-04-01
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| Series: | Journal of Lipid Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0022227520311706 |
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| author | Nirupa R. Matthan Ann Giovanni Ernst J. Schaefer B.Greg Brown Alice H. Lichtenstein |
| author_facet | Nirupa R. Matthan Ann Giovanni Ernst J. Schaefer B.Greg Brown Alice H. Lichtenstein |
| author_sort | Nirupa R. Matthan |
| collection | DOAJ |
| description | The HDL Atherosclerosis Treatment Study (HATS) demonstrated a clinical benefit in coronary artery disease patients with low HDL cholesterol (HDL-C) levels treated with simvastatin and niacin (S-N) or S-N plus antioxidants (S-N+A) compared with antioxidants alone or placebo. Angiographically documented stenosis regressed in the S-N group but progressed in all other groups. To assess the mechanism(s) responsible for these observations, surrogate markers of cholesterol absorption and synthesis were measured in a subset of 123 HATS participants at 24 months (on treatment) and at 38 months (off treatment). Treatment with S-N reduced desmosterol and lathosterol levels (cholesterol synthesis indicators) 46% and 36% (P < 0.05), respectively, and elevated campesterol and β-sitosterol levels (cholesterol absorption indicators) 70% and 59% (P < 0.05), respectively, relative to placebo and antioxidant but not S-N+A. Treatment with antioxidants alone had no significant effect. Combining S-N with antioxidants reduced desmosterol and lathosterol by 37% and 31%, and elevated campesterol and β-sitosterol levels by 54% and 46%, but differences did not attain significance. Mean change in percent stenosis was positively associated with a percent change in lathosterol (r = 0.26, P < 0.005) and negatively associated with a percent change in β-sitosterol (r = −0.21, P < 0.01).These data suggest that changes in stenosis were attributable, in part, to changes in cholesterol metabolism. |
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| id | doaj.art-1af836e148ce44e69f34369b26a299b7 |
| institution | Directory Open Access Journal |
| issn | 0022-2275 |
| language | English |
| last_indexed | 2024-12-18T01:22:17Z |
| publishDate | 2003-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Lipid Research |
| spelling | doaj.art-1af836e148ce44e69f34369b26a299b72022-12-21T21:25:47ZengElsevierJournal of Lipid Research0022-22752003-04-01444800806Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDLNirupa R. Matthan0Ann Giovanni1Ernst J. Schaefer2B.Greg Brown3Alice H. Lichtenstein4Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Division of Cardiology, University of Washington, Seattle, WA 98195Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Division of Cardiology, University of Washington, Seattle, WA 98195Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Division of Cardiology, University of Washington, Seattle, WA 98195Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Division of Cardiology, University of Washington, Seattle, WA 98195Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; Division of Cardiology, University of Washington, Seattle, WA 98195The HDL Atherosclerosis Treatment Study (HATS) demonstrated a clinical benefit in coronary artery disease patients with low HDL cholesterol (HDL-C) levels treated with simvastatin and niacin (S-N) or S-N plus antioxidants (S-N+A) compared with antioxidants alone or placebo. Angiographically documented stenosis regressed in the S-N group but progressed in all other groups. To assess the mechanism(s) responsible for these observations, surrogate markers of cholesterol absorption and synthesis were measured in a subset of 123 HATS participants at 24 months (on treatment) and at 38 months (off treatment). Treatment with S-N reduced desmosterol and lathosterol levels (cholesterol synthesis indicators) 46% and 36% (P < 0.05), respectively, and elevated campesterol and β-sitosterol levels (cholesterol absorption indicators) 70% and 59% (P < 0.05), respectively, relative to placebo and antioxidant but not S-N+A. Treatment with antioxidants alone had no significant effect. Combining S-N with antioxidants reduced desmosterol and lathosterol by 37% and 31%, and elevated campesterol and β-sitosterol levels by 54% and 46%, but differences did not attain significance. Mean change in percent stenosis was positively associated with a percent change in lathosterol (r = 0.26, P < 0.005) and negatively associated with a percent change in β-sitosterol (r = −0.21, P < 0.01).These data suggest that changes in stenosis were attributable, in part, to changes in cholesterol metabolism.http://www.sciencedirect.com/science/article/pii/S0022227520311706desmosterollathosterolcampesterolβ-sitosterolcholesterol synthesischolesterol absorption |
| spellingShingle | Nirupa R. Matthan Ann Giovanni Ernst J. Schaefer B.Greg Brown Alice H. Lichtenstein Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL Journal of Lipid Research desmosterol lathosterol campesterol β-sitosterol cholesterol synthesis cholesterol absorption |
| title | Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL |
| title_full | Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL |
| title_fullStr | Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL |
| title_full_unstemmed | Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL |
| title_short | Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL |
| title_sort | impact of simvastatin niacin and or antioxidants on cholesterol metabolism in cad patients with low hdl |
| topic | desmosterol lathosterol campesterol β-sitosterol cholesterol synthesis cholesterol absorption |
| url | http://www.sciencedirect.com/science/article/pii/S0022227520311706 |
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