The effect of atorvastatin on serum lipids, lipoprotein(a) and plasma fibrinogen levels in primary dyslipidaemia - A pilot study involving serial sampling

We conducted an open-label study to test the effects of atorvastatin on ser um lipids, lipoprotein(a) [Lp(a)] and plasma fibrinogen levels. A total of 90 dyslipidaemic, nonsmoking patients (45 patients with primary hypercholes terolaemia and 45; patients with primary mixed hyperlipidaemia) aged 48 +/- 11 years were studied. The patients were treated with 20 mg of atorvastati n for 24 weeks, in a single nocturnal dose. Ar baseline and every eight wee ks, the fasting lipid profile, together with serum Lp(a) and plasma fibrino gen levels (Clauss method), were measured. Atorvastatin was highly effectiv e in normalising the serum lipid profile. No significant change in median s erum Lp(a) levels was observed in the whole group of patients (0.14g/l befo re, vs. 0.16g/l after treatment) as well as in patients with raised > 0.30g /l) baseline levels (n = 32). A small non-significant increase of plasma fi brinogen was found (3.04g/l vs. 3.14g/l) after 24 weeks of atorvastatin adm inistration. The effects of atorvastatin on both these variables did Mot di ffer in patients with hypercholesterolaemia or mixed hyperlipidaemia. In conclusion, our findings suggest that the effect of atorvastatin on plas ma fibrinogen levels in dyslipidaemic patients without evident vascular dis ease is not clinically relevant. Furthermore, any rise in fibrinogen levels that may occur is likely to be transient in nature. Further studies are ne cessary to clarify this issue. There was no evidence that atorvastatin infl uences serum Lp(a) levels.