Effect of Pravastatin on intermediate-density and low-density lipoproteins containing apolipoprotein CIII in patients with diabetes mellitus

Sung Joon Lee, Frank M. Sacks

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13 Citations (Scopus)


The apolipoprotein (apo) B lipoproteins, intermediate-density lipoproteins (IDL) and low-density lipoproteins (LDL) that contain apo-CIII are associated with coronary heart disease in patients with diabetes mellitus. Apo-CIII is prominent in diabetic dyslipidemia. We studied whether these apo-B lipoprotein types containing apo-CIII in diabetics are reduced by 1 year of pravastatin treatment. We randomly selected 45 age- and gender-matched placebo/pravastatin pairs from diabetic patients in the Cholesterol and Recurrent Events trial, a randomized, double-blinded trial of pravastatin 40 mg monotherapy. Very-low-density lipoproteins (VLDL) and IDL + LDL particles were subdivided based on the presence of apo-E and apo-CIII to yield 3 particle types: E+CIII+, E-CIII+, and E-CIII-. Compared with placebo, pravastatin reduced IDL + LDL apo-B concentrations for E+CIII+, E-CIII+, and E-CIII- by 42% (p = 0.02), 17% (p = 0.7), and 29% (p = 0.002), respectively, commensurate with IDL + LDL cholesterol concentration reductions in the particle types of 29% (p = 0.002), 25% (p = 0.2), and 36% (p <0.0001), respectively. These IDL + LDL CIII+ particles are rich in triglycerides and cholesterol and are likely to be remnant particles of VLDL. Thus, pravastatin reduced potentially atherogenic remnant particles, a prominent component of diabetic dyslipidemia associated with coronary events; these results may contribute to its demonstrated effectiveness in reducing coronary heart disease in diabetics.

Original languageEnglish
Pages (from-to)121-124
Number of pages4
JournalAmerican Journal of Cardiology
Issue number2
Publication statusPublished - 2003 Jul 15

Bibliographical note

Funding Information:
This study was supported by an investigator-initiated grant from Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, New Jersey, to the investigator-controlled ancillary studies fund of the Cholesterol and Recurrent Events trial. The investigators had the contractual right to design and publish the research.

Copyright 2017 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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