Effects of atorvastatin and omega-3 fatty acids on LDL subfractions and postprandial hyperlipemia in patients with combined hyperlipemia

Background and Aim: The aim of the present study was to see whether a moder ate dose of omega -3 fatty acids (FA) potentiates the beneficial effects of statins on the high risk for coronary heart disease (CHD) in patients with combined hyperlipemia. Methods and Results: In the present double-blind parallel study, 42 patient s with combined hyperlipemia with serum triglycerides 2-15 mmol/L-1 and ser um total cholesterol >5.3 mmol/L-1 at the end of a three-month dietary run- in period were treated with 10 mg/d atorvastatin for 10 or more weeks. Duri ng the last 5 weeks they were randomized into two groups that received eith er 1.68 g/d omega -3 FA as ethylesters of eicosapentaenoic (45%) and docosa hexaenoic acids (39%), or placebo (corn oil). As expected, atorvastatin sig nificantly reduced serum total LDL-cholesterol (LDL-C), triglycerides and a polipoproteins B, E, CII and CIII, whereas HDL-cholesterol (HDL-C) was incr eased. Addition of omega -3 FA further increased HDL-C (p <0.03), and reduc ed systolic blood pressure (<0.03), while the small dense LDL-particles (LD L III) (p <0.05) and postprandial hypertriglyceridemia (p <0.01) were reduc ed compared with the baseline, though there were no significant differences to the placebo group. This may be related to the large individual variatio n in these parameters and the small number of patients. No significant effe cts on basic or postheparin activities of lipoprotein lipase or hepatic lip ase were observed after atorvastatin with or without addition of omega -3 F A. Conclusions: This study indicates that addition of a low close of omega -3 FA may further improve the risk profile Sor CHD in patients with combined h yperlipemia treated with atorvastatin, The effect is related to reduction o f postprandial hyperlipemia and redistribution of LDL subfractions. (C) 200 1, Medikal Press.