EFFECTS OF ACIPIMOX ON HEMORHEOLOGY AND PLASMA-LIPOPROTEINS IN PATIENTS WITH MIXED HYPERLIPOPROTEINEMIA

Aims Epidemiological data have shown that haemorheological disorders a re associated with an increased risk of atherosclerosis. We evaluated the effect of the nicotinic acid derivative acipimox on haemorheologic al and lipid parameters in 18 patients with mixed hyperlipoproteinaemi a using a randomized, double-blind, placebo-controlled, cross-over stu dy protocol. Methods Patients (7 women, 11 men, aged 49.3+/-3.0 years) were investigated with acipimox (dose adjusted to weight, 500 or 750 mg daily) compared with placebo treatment each for 12 weeks. Lipid par ameters, whole blood viscosity, plasma viscosity, fibrinogen, and red cell aggregation at native and standardized (0.45) haematocrit as well as red cell filterability were measured at baseline, at week 12 (chan ge of therapy), and at week 24. Results Total cholesterol concentratio n (8.30+/-0.32 vs 8.72+/-0.36 mmol/l(-1)) and apolipoprotein B (198.5/-9.9 vs 217+/-9.9 mg dl(-1)) were significantly lower (P<0.05) during acipimox therapy compared with placebo, no significant changes were o bserved for triglycerides and low-density lipoprotein [LDL] cholestero l. However, total high-density lipoprotein [HDL] cholesterol (1.24+/-0 .05 vs 1.10+/-0.05 mmol l(-1) P<0.001) as well as HDL2 and HDS cholest erol (P<0.05) were significantly er during acipimox therapy. The LDL c holesterol to HDL cholesterol ratio significantly improved during acip imox therapy (4.63+/-0.25 vs 5.49+/-0.26, P<0.001). Red cell aggregati on at native and standardized haematocrit were the only haemorheologic al parameters which improved during acipimox therapy in comparison wit h placebo (shear rate 3 s(-1): 10.69+/-0.40 vs 11.50+/-0.44 U, P<0.05, for native red cell aggregation; 10.40+/-0.36 vs 11.28+/-0.39 U, P<0. 05, for standardized red cell aggregation). Conclusions We conclude, t hat the cardiovascular risk profile improves during acipimox therapy d ue to an elevation in HDL cholesterol and its subfractions as well as a decrease in red cell aggregation.