EFFECT OF GEMFIBROZIL VERSUS LOVASTATIN ON INCREASED SERUM LIPOPROTEIN(A) LEVELS OF PATIENTS WITH HYPERCHOLESTEROLEMIA

The aim of this study was to determine the effect of gemfibrozil, comp ared with lovastatin, in patients with high levels of lipoprotein(a) a nd on plasma lipid profile. Twenty-seven nondiabetic patients with hig h levels of plasma lipids and lipoprotein(a), 19 male and eight female , aged 37-68 (mean +/- S.D. 54.2 +/- 7.5) years, were randomly assigne d to 12 weeks of treatment with gemfibrozil 600 mg twice daily (14 pts .) or lovastatin 40-80 mg once daily (13 pts.). Patients had fasting p lasma total cholesterol levels greater than or equal to 6.2 mmol/l, lo w-density lipoprotein > 4. 14 mmol/l and lipoprotein(a) > 0.62 mmol/l. All patients but one had triglycerides > 2.82 mmol/l. There were no s tatistical differences between both groups in terms of age, sex, clini cal diagnosis and previous medication. After 3 months of treatment, ge mfibrozil reduced triglycerides (47.9% vs. 24.5%; P < 0.001), very low density lipoprotein (43.9% vs. 24.6%; P < 0.05), lipoprotein(a) (25.3 % vs. 4.9%; P < 0.05) and increased high-density lipoprotein (34.4% vs . 11%; P < 0.01) more than lovastatin. Gemfibrozil and lovastatin redu ced comparably total cholesterol (21.4% vs. 29.0%; P = NS) and low-den sity lipoprotein (26.5% vs. 37.3%; P = NS). The plasma levels of high- density lipoprotein and lipoprotein(a) were unchanged significantly by lovastatin. In conclusion, besides well-known efficacy in hyperlipide mia treatment, gemfibrozil also increased high-density lipoprotein and reduced lipoprotein(a), which may have important epidemiologic implic ations.