Author + information
- Bobbi Hollaway,
- Cheryl Jensen,
- Haeli Steinmann,
- Heidi May,
- Donald Lappe,
- Jeffrey Anderson and
- J. Muhlestein
Statin therapy is well documented to lower cholesterol and prevent cardiovascular adverse events. However, 10-15% of patients cannot tolerate many statins due to the development of myalgias. Pitavastatin, a newer statin, is minimally affected by the cytochrome P450 system, water soluble so it doesn't enter the brain, and does not lower Co-enzyme Q10. However, whether these special biochemical characteristics make pitavastatin both usable and efficacious among patients who have not been able to tolerate other statins is not known.
A total of 40 consecutive patients with documented intolerance to any dose of at least two different statins were prospectively enrolled into a protocol whereby they received a trial of pitavastatin therapy at a dose of 2 mg per day. Initially pitavastatin samples were provided and if they could tolerate the regimen, a long-term prescription was given. Baseline clinical characteristics in all patients and fasting baseline and post-pitavastatin treatment fasting LDL cholesterol levels were obtained in all patients found to tolerate pitavastatin therapy.
A total of 40 patients (mean age = 65 years; males = 40%, documented CAD = 50%; hypertension = 80%, diabetes = 18%, positive family history of CAD = 58%, smoker = 10%) were enrolled in the protocol. Of these 27 (68%) were able to tolerate the pitavastatin samples and continued on maintenance pitavastatin therapy. Among those able to tolerate pitavastatin, baseline fasting LDL cholesterol was reduced from 147±27 mg/dL to 93±25 mg/dL, resulting in an average LDL-cholesterol reduction of 34%. Patients who could best tolerate pitavastatin tended to be males and those with no history of coronary artery disease or diabetes.
Low dose pitavastatin is an acceptable alternative to abandoning statin therapy among two thirds of patients documented to be intolerant to other statins, providing an average LDL-cholesterol reduction of 34%.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Treatment of Hyperlipidemia
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1275-16
- 2013 American College of Cardiology Foundation