CHANGES INDUCED BY PRAVASTATIN TREATMENT ON HEMOSTATIC AND FIBRINOLYTIC PATTERNS IN PATIENTS WITH TYPE IIB HYPERLIPOPROTEINEMIA

A randomized, double-blind, parallel-group study of pravastatin versus placebo was carried out for 24 weeks in 20 patients with type IIb pri mary hyperlipoproteinemia. Total cholesterol, triglycerides, high-dens ity lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) chole sterol, blood glucose, apolipoproteins (apo) A1 and B, and lipoprotein (a) (Lp[a]) levels were determined. A venous occlusion test was also performed in all patients. Pre- and postvenous occlusion tests were de termined: tissue plasminogen activator antigen (t-PA[Ag]), plasminogen activator inhibitor (PAI) activity, factor VII, fibrinogen, plasminog en, and hematocrit. Compared with placebo, pravastatin significantly r educed total cholesterol, LDL cholesterol, apo B, and triglyceride lev els, as well as significantly increased HDL cholesterol and apo A1 lev els. A mild, statistically nonsignificant reduction in Lp(a) was obser ved in the patients treated with pravastatin. Compared with placebo, p ravastatin significantly reduced factor VII, fibrinogen, plasminogen, and PAI activity levels before and after venous occlusion. A significa nt reduction of t-PA(Ag) at rest was found in patients treated with pr avastatin, whereas there was no significant difference in t-PA(Ag) lev els after venous occlusion. Our data confirm the well-known lipid-regu lating effect of pravastatin and suggest a positive effect of pravasta tin on the regulation of hemostatic and fibrinolytic systems in patien ts with type IIb hyperlipoproteinemia.