Korean Circ J.  2008 Jan;38(1):36-42. 10.4070/kcj.2008.38.1.36.

Changes of the Lipoprotein Profiles with Time after Discontinuation of Statin Therapy

• Kim MK
• Kim HL
• Min HS
• Kim MS
• Yoon YE
• Park KW
• Kim SH
• Zo JH
• Kim MA
• Moon HJ
• Kim HS
• Sohn DW
• Oh BH
• Park YB
• Choi YS

• KMID: 2225872
• DOI: http://doi.org/10.4070/kcj.2008.38.1.36

Abstract

BACKGROUND AND OBJECTIVES
Some patients stop statin therapy in spite of their doctors' advice. This study was designed to assess the pattern of lipoprotein profile changes and clinical characteristics of the patients who discontinued statin therapy.
SUBJECTS AND METHODS
69 patients (male 42.0%) were enrolled. The clinical characteristics and laboratory data on the lipoprotein levels were obtained from the medical records.
RESULTS
The coexistence of diabetes mellitus (DM) was seen in 28% of the patients, hypertension was noted in 72% and coronary artery disease (CAD) was noted in 42%. The average lipoprotein levels during statin therapy were total cholesterol (TC)=163.8 mg/dL, triglycerides (TG)=174.3 mg/dL, high-density lipoprotein cholesterol (HDL-C)=34.8 mg/dL and low-density lipoprotein cholesterol (LDL-C)=94.2 mg/dL. LDL-C level increased by 44.9% at 2-3 months after ceasing statin therapy and by 54.6% at 4-6 months after ceasing statin therapy (p<0.01). The changes of the lipoprotein levels from baseline to 2-3 months and 4-6 months after discontinuation were +22.6% and +30.0% for the TC level, +20.8% and +24.0% for the TG level, and 0.06% and -0.65% for the HDL-C level respectively (p<0.01 for TC and TG, p=not significant (NS) for HDL-C). The achievement rate of target LDL-C level as suggested by the Adult Treatment Panel III (ATP III) of National Cholesterol Education Program (NCEP) was decreased 62.7% at 2-3 months and then it was decreased to 61.8% at 4-6 months after statin discontinuation. DM and CAD were more frequent in the patients who did not achieve the target LDL-C level even with life style modification.
CONCLUSION
After statin discontinuation, TC and LDL-C were increased within 3 months. DM and CAD were highly prevalent in patients who didn't achieve their treatment goal.

Keyword

Statin; Lipoprotein; Cholesterol

MeSH Terms

Achievement
Adult
Cholesterol
Coronary Artery Disease
Diabetes Mellitus
Humans
Hypertension
Life Style
Lipoproteins
Medical Records
Triglycerides
Cholesterol
Lipoproteins
Triglycerides

Figure

• 

  Fig. 1. The changes of serum lipoprotein levels after statin discontinuation. ∗p<0.001. TC: total cholesterol, TG: triglycerides, HDL-C: high-density lipoprotein cholesterol, LDL-C: low-density lipoprotein cholesterol.

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  Fig. 2. The percentages of patients whose HDL-C levels were lower than 40 mg/dL (p=NS). HDL-C: high-density lipoprotein cholesterol.

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  Fig. 3. The achievement rate of target LDL-C level by NCEP-ATP III guideline. ∗p<0.001 when compared with goal-achievement rate during statin therapy. LDL-C: low-density lipoprotein cholesterol. NCEP-ATP III: National Cholesterol Education Program Adult Treatment Panel III.

Reference

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