Abstract
High lipoprotein(a) (Lp[a]) levels appear to be a risk factor for coronary artery disease and thrombosis because of possible interference with the fibrinolytic system. This study examined the effect of the lipid-lowering drug etofibrate (500 mg twice daily) on Lp(a) serum levels, fibrinogen, and plasma lipids in a group of 10 hypercholesterolemic patients with high baseline levels of Lp(a). Lp(a) concentrations decreased by 7.3% (mean values) or 17.6% (median values) after 4 months of treatment. Reductions were seen in all patients who had a baseline Lp(a) level greater than 50 mg/dL. Fibrinogen was reduced by 9.6% (mean values). Statistically significant decreases were seen in the mean values of total cholesterol (15.7%) and in low-density lipoprotein cholesterol (21.2%). Apolipoprotein B levels also decreased, whereas high-density lipoprotein (HDL) cholesterol, HDL 2 and HDL 3 subfractions, and apolipoprotein AI did not change significantly. Triglycerides (mean values) were normal at baseline and further decreased during therapy. Because of the known correlation between hyperlipoproteinemia and disturbances of blood clotting and rheology, it should be useful to lower lipids as well as to reduce Lp(a) and other thrombogenic factors to prevent atherosclerotic diseases. The effects of etofibrate on patients' Lp(a) levels shown in this study should be further investigated in larger patient populations.
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