Lipid-modifying and pleiotropic effects of gemfibrozil, simvastatin and pravastatin in patients with dyslipidemia.

AIM: To assess the lipid-modifying and pleiotropic effects of drugs of the statin group (simvastatin and pravastatin) and the fibrate group (gemfibrozil) in dyslipidemia patients. PATIENTS AND METHODS: Fifty eight patients with primary dysli pidemia were recruited for a 12-week treatment. Forty two patients were allocated to be treated with statins (20 mg): 24 with simvastatin and 18 with pravastatin. Sixteen patients received gemfibrozil in a dose of 900 mg daily. Using enzyme, colorimetric, turbidimetric, immunoenzyme and chromogenic substrate methods, we studied the following laboratory parameters: 1) lipid parameters - total cholesterol, LDL and HDL cholesterol, triglycerides, apoli poprotein A-I, apoli poprotein B, anticardioli pin antibodies and lipid indices; 2) hemostasis, fibrinolysis and blood rheology parameters - platelet count, ADP-induced platelet aggregation, fibrinogen, platelet factor 4,antithrombin III activity, alpha2-anti plasmin concentrations, alpha2-macroglobulin, alpha1-antitripsin, plasma viscosity and hematocrit. RESULTS: Gemfibrozil elevated significantly apolipoprotein A-I, but decreased the total cholesterol, LDL cholesterol, triglycerides, the lipid indices, the ADP-induced platelet aggregation, plasminogen, alpha2-antiplasmin and hematocrit. Simvastatin treatment of patients reduced the total cholesterol, LDL cholesterol, triglycerides, two of the lipid indices, plasma viscosity and hematocrit. Pravastatin produced the same changes in the lipid parameters, but decreased apolipoprotein A-I. Plasminogen, alpha2-antiplasmin and rheological parameters decreased while antithrombin III increased. CONCLUSION: The lipid-modifying treatment with statins and fibrates, in addition to the effect on lipid metabolism, exerts a pleiotropic effect on hemostasis, fibrinolysis and blood rheology parameters.