Long-term administration of pravastatin reduces serum lipoprotein(a) levels.

Background: The long-term effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on serum lipoprotein(a) (Lp(a)) levels has been poorly investigated. Objective: This study sought to examine the effect of 24 months' administration of pravastatin on serum Lp(a) levels. Subjects: 23 patients with coronary artery disease and serum low-density lipoprotein (LDL) cholesterol levels of 120 mg/dl or above were included. Method: Serum levels of lipids and Lp(a) were serially determined after the administration of pravastatin for 24 months. Results: Serum LDL-cholesterol (LDL-C) levels significantly decreased from 1 month after the drug administration and the reduction persisted for 24 months, whereas Lp(a) levels did not decrease at 3 months after the administration but significantly decreased at 12 months or more. The reduction in the Lp(a) levels was not related to the dose ofpravastatin. Conclusions: The results indicated that long-term administration of pravastatin for 12 months or more significantly reduced serum Lp(a) levels and the reduction of Lp(a) levels occurred much later than that of LDL-C levels. The delayed reduction in serum Lp(a) levels after the administration of pravastatin may be associated with a retarded inhibition of Lp(a) synthesis by the drug.