HMG-Co-A reductase inhibitors in the treatment of hypercholesterolemic renal transplant recipients

Hippokratia 1999, 3(4):171-176

G Vergoulas, Gr Miserlis, D Gakis, A Papagiannis, V Papanikolaou, D Takoudas, A Antoniadis


Abstract

The aim of this study was to compare the safety and efficacy of lovastatin and fluvastatin in the treatment of hypercholesterolemic (HCH) renal transplant recipients (RTR). Fifty steady HCH RTR received either 20 mg/d lovastatin (Group A = 22 pts, mean age: 40 yrs) or 40 mg/d fluvastatin (Group Β = 28 pts, mean age: 41 yrs) for a period of one year. Total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and triglycerides (TG) were measured before and at the end of the 3rd and 12th month of treatment. Serum creatinine (Scr), SGOT, SGPT, CPK and total bilirubin (TB) were measured at the same time intervals. ANOVA for repeated measures and independent t test were used for statistical analysis. The TC levels were 304.54±38.38 mg/dl, 234.95±38.12 mg/dl, 240.23±39.09 mg/dl and 323.25±49.61 mg/dl (p:NS), 263.74±38.05 mg/dl (p:0.01), 262.90±31.39 mg/dl (p: 0.04), HDL-C levels were 43.83±11.23 mg/dl, 49.06±7.44 mg/ dl, 55.33±16.30 mg/dl and 46.08±12.77 mg/dl, 52.45±21.60 mg/dl, 55.33±16.30 mg/dl, LDL-C levels were 214.22v41.59 mg/dl, 169.33±41.76 mg/dl, 159.56+35.12 mg/dl and 237.52±53.80 mg/dl, 182.50±43.02 mg/dl, 178.05± 28.47 mg/dl, TG levels were 191.59±59.92 mg/dl, 155.53±53.67 mg /dl, 142.95±48.57 and 188.29±63.09 mg/dl, 151.59±54.09, 156.54±53.27 mg/dl in the Group A and Β at the measured time intervals respectively. In Group A serum TC (p=0.0001), LDL-C (p=0.025), andTG (p=0.002) levels and in Group BTC(p=0.0001), LDL-C (p=0.005) and TG (p=0.044) levels showed statistically significant (ss) fall at the end of 3rd and 12th month. Serum HDL-C did not show any significant change during time in either group. Serum total cholesterol levels of Group A were significantly lower than those of Group Β at 3rd and 12th month of treatment. Scr levels remained stable and no change was noticed in CPK, SGOT, SGPT, TB in both groups.Lovastatin and fluvastatin are safe and cause significant fall of serum TC, LDL-C and TG levels. This fall is evident from the first three months of treatment. Lovastatin causes a deeper fall of serum TC at the 3rd and 12th month than fluvastatin(ss). Both drugs have no significant effect on HDL-C levels.