Zambrana García J L, López Miranda J, Anguita Sánchez M, Blanco Cerrada J, Vallés Belsúe F, Casares Mediavilla J, Muñoz Carvajal I, Jiménez Perepérez J A, Pérez Jiménez F
Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofía, Córdoba.
Rev Esp Cardiol. 1996 Dec;49(12):892-8.
Coronary artery disease is a major limiting factor for long-term survival after heart transplantation. Hyperlipidemia is a probable risk factor for coronary artery disease in this kind of patient. Bezafibrate and lovastatin have proved to be effective in lowering total and low density lipoprotein cholesterol. The present study tested the safety and efficacy of both drugs on lipid levels in 21 patients with post-heart transplantation hyperlipidemia.
Patients maintained the same diet for three months. Then, they were randomized to lovastatin (20 mg/day) or bezafibrate (400 mg/day) for 8 weeks, and then, crossovered to an additional 8 weeks of bezafibrate or lovastatin.
Both drugs were effective in lowering total and low density lipoprotein cholesterol and apoprotein B concentrations, but the effect of lovastatin was significantly greater. Only bezafibrate produced a significant reduction in total triglycerides and a significant rise in high density lipoprotein cholesterol and apoprotein AI. The total cholesterol/high density lipoprotein cholesterol and low density lipoprotein cholesterol/high density lipoprotein cholesterol ratios were decreased under both treatments.
Both drugs, bezafibrate and lovastatin appear to be safe, effective and well-tolerated therapies for hyperlipidemia in cardiac transplant recipients.
冠状动脉疾病是心脏移植后长期生存的主要限制因素。高脂血症可能是这类患者患冠状动脉疾病的危险因素。已证明苯扎贝特和洛伐他汀在降低总胆固醇和低密度脂蛋白胆固醇方面有效。本研究测试了这两种药物对21例心脏移植后高脂血症患者血脂水平的安全性和有效性。
患者维持相同饮食三个月。然后,他们被随机分为服用洛伐他汀(20毫克/天)或苯扎贝特(400毫克/天)8周,之后交叉服用另一种药物8周。
两种药物在降低总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B浓度方面均有效,但洛伐他汀的效果更显著。只有苯扎贝特能显著降低总甘油三酯,并显著提高高密度脂蛋白胆固醇和载脂蛋白AI。两种治疗方法均使总胆固醇/高密度脂蛋白胆固醇和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值降低。
苯扎贝特和洛伐他汀这两种药物似乎都是心脏移植受者高脂血症安全、有效且耐受性良好的治疗方法。