Aim: The effects of statin on small dense low-density lipoprotein cholesterol (sd-LDL-C) and remnant-like particle cholesterol (RLP-C) levels in heterozygous familial hypercholesterolemia (FH) have not been examined. This study aimed to clarify the effects of statin on sd-LDL-C and RLP-C levels in heterozygous FH.
Methods: Seventeen patients with heterozygous FH were randomly assigned to 2 mg/day pitavastatin or 10 mg/day atorvastatin. At baseline and 12 weeks after treatment with statin, we measured sd-LDL-C and RLP-C levels.
Results: Sd-LDL-C levels significantly decreased from 43 ± 24 to 16 ± 10 mg/dL (−63%, p=0.001) in the pitavastatin group, and from 44 ± 17 to 19 ± 10 mg/dL (−55%, p<0.001) in the atorvastatin group. RLP-C levels decreased from 8.4 ± 2.8 to 6.6 ± 2.7 mg/dL (−16%, p=0.156) in the pitava-statin group, and from 9.8 ± 4.7 to 5.9 ± 5.4 mg/dL (−45%, p=0.044) in the atorvastatin group. There were no significant differences in percent changes of sd-LDL-C (p=0.370) and RLP-C levels (p=0.097) between the two groups.
Conclusions: Sd-LDL-C measured by the heparin-magnesium precipitation method and RLP-C levels in heterozygous FH were decreased by 12 weeks of statin therapy. Statin might have additional anti-atherogenic effects by reducing not only LDL-C but also sd-LDL-C and RLP-C.