promega and Hyperlipidemias

Topics: Coronary Disease; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Fish Oils; Humans; Hyperlipidemias; Triglycerides

Accelerated coronary artery disease is the most serious obstacle to long-term survival in cardiac transplant recipients. Lipid abnormalities are found frequently in these patients, and there is growing evidence that even minimally increased levels of cholesterol and triglycerides contribute to the development of accelerated coronary artery disease. However, the optimal lipid-lowering therapy after cardiac transplantation has not been defined. In an open, randomized study, the efficacy and safety of bezafibrate (400 mg/day) and fish oil (Maxepa) (10 g/day) for 3 months were compared in 87 cardiac transplant recipients with serum total cholesterol > 6.5 or triglycerides > 2.8 mmol/liter, or both. After 1 month, bezafibrate reduced total cholesterol by 13%, low-density lipoprotein cholesterol by 20% and apolipoprotein B by 13%. It also increased apolipoprotein A1 and high-density lipoprotein cholesterol by 12 and 20%, respectively, and significantly reduced fibrinogen at 3 months. Maxepa had no significant effect on these variables, but was as effective as bezafibrate in reducing triglycerides (36 and 31%, respectively). Both drugs increased lipoprotein (a) to a similar extent, and bezafibrate significantly increased serum creatinine. These results suggest that bezafibrate has better lipid-, apolipoprotein- and hemostatic modifying properties than does Maxepa, but its potentially adverse effect on renal function needs further investigation.

Topics: Apolipoprotein A-I; Apolipoproteins B; Bezafibrate; Cholesterol; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Female; Fish Oils; Heart Transplantation; Humans; Hyperlipidemias; Lipoprotein(a); Male; Time Factors; Triglycerides

An encapsulated preparation of fish oil (Maxepa) was administered to hyperlipidaemic patients in order to establish the responsiveness of the common lipid phenotypes to dietary supplementation with n-3 fatty acids. 13 patients took 6 g/day of fish oil and 12 patients took 16 g/day in a randomized, double-blind crossover study, whereby each subject took fish oil for 3 months and matching placebo for 3 months. The study was conducted against a background diet restricted in saturated fat and cholesterol. In Types IIa and IIb hyperlipoproteinaemia there was no substantial fall in plasma cholesterol concentration. Plasma triglyceride concentrations were reduced significantly in Types IIb and IV (28% and 41% respective reductions). In a separate study using 16 g/day of fish oil in patients with Type V hyperlipoproteinaemia, plasma triglycerides were reduced by 58% and plasma cholesterol concentration by 34%. The change in plasma triglyceride concentration was significantly correlated with the basal triglyceride level (r = -0.94), and was dose-related (33% fall on 6 g/day and 58% fall on 16 g/day). The fall in plasma triglyceride concentration was accompanied by a significant reduction in the concentration of very low-density lipoprotein cholesterol (-42%), a significant rise in low density lipoprotein cholesterol (+7%), and a significant rise in high-density lipoprotein cholesterol concentration (+6%), there being no significant change in the ratio of low density to high density lipoprotein cholesterol. There were changes in the fatty acid composition of plasma and platelet lipids which reflected dietary supplementation with n-3 fatty acids, notably an increase in the proportion of eicosapentaenoic and docosahexaenoic acids which occurred in a dose-dependent fashion. Despite these changes there was no significant variation in the bleeding time, platelet count or blood viscosity during the treatment.

Topics: Adult; Aged; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Cholesterol, VLDL; Clinical Trials as Topic; Docosahexaenoic Acids; Double-Blind Method; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Hyperlipidemias; Hyperlipoproteinemia Type II; Hyperlipoproteinemia Type IV; Hyperlipoproteinemia Type V; Lipids; Lipoproteins; Lipoproteins, VLDL; Male; Middle Aged; Triglycerides

Topics: Adult; Aged; Clinical Trials as Topic; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Hyperlipidemias; Lipids; Male; Middle Aged

Topics: Cod Liver Oil; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Fish Oils; Humans; Hyperlipidemias; Triglycerides