Effect of pravastatin on plasma removal at a chylomicron-like emulsion in men with coronary artery disease

The speed of the plasma removal of chylomicrons, the lipoproteins that carr y dietary lipids absorbed in the intestine, may influence atherogenesis. Th us, the effects of a 30-day pravastatin or placebo treatment on the plasma kinetics of chylomicron-like emulsions were evaluated in 25 patients with c oronary artery disease who were not hypertriglyceridemic in a randomized, s ingle-blinded study. Eleven patients (53 +/- 4 years, 10 men) received prav astatin 40 mg/day and 14 received placebo (52 +/- 3 years, 13 men). Emulsio ns labeled with triolein (H-3-TO) and cholesteryl oleate (C-14-CO) to asses s lipolysis and clearance of chylomicron and remnants, respectively, were i njected intravenously in a bolus after a 12-hour fast. Blood samples were c ollected during 60 minutes to determine radio isotope decaying curves and f ractional catabolic rates. Subjects were studied at baseline and after the treatment period. Compared with placebo (data expressed as mean a SEM), pra vastatin treatment increased the C-14-CO fractional catabolic rates (70 +/- 45% vs 18 +/- 10%, p = 0.01), reduced total cholesterol (-21 +/- 3% vs -3 +/- 2% p = 0.0001), low-density lipoprotein (LDL) cholesterol (-25 +/- 5% v s 4 +/- 6%, p = 0.0001), and apolipoprotein B levels (-22 +/- 3% vs -7 +/- 3% p = 0.01). H-3-TO fractional catabolic rates, plasma triglycerides, very -low-density lipoprotein (VLDL) cholesterol and high-density lipoprotein (H DL) cholesterol variations did not differ between the groups. The fractiona l catabolic rate of C-14-CO was inversely correlated with plasma apolipopro tein B levels (r = -0.7, p = 0.04). This suggests that besides reducing LDL cholesterol, pravastatin also increases chylomicron remnant clearance, wit h possible antiatherogenic implications. (C) 2000 by Excerpta Medico, Inc.