BACKGROUND: HMG CoA (beta-hydroxy-beta-methylglutaryl coenzyme A) reductase inhibitors are very effective in lowering total and low-density lipoprotein cholesterol. Since the introduction of lovastatin for clinical use in the United States in 1987, statins have become widely available and the number of patients treated with these compounds is estimated to be over 2 million. The incidence of adverse effects is very low with elevated transaminase levels and myopathy being of greatest concern. Currently, several intervention trials demonstrated the influence of HMG CoA reductase inhibitors on total and cardiovascular morbidity and mortality and on regression of atherosclerosis as well. Fluvastatin, LESCOLR, a synthetic drug, is the most recently approved HMG CoA reductase inhibitor. PATIENTS METHODS AND STUDY DESIGN: At the lipid clinic 18 patients (8 familial hypercholesterolemia heterozygotes and 10 subjects affected with familial combined hyperlipidemia) have been treated with increasing dose of fluvastatin (20 and 40 mg/day with the evening meal) for 3 months. All patients respected AHA step I diet. The basic parameters of lipid and lipoprotein metabolism have been measured, and apo A-I, apo B levels as well.

RESULTS: Concentration of total cholesterol decreased after treatment with 20 and 40 mg of fluvastatin by 17% resp. 23%. The hypolipidemic effect was even more pronounced in LDL-cholesterol level, which was reduced by 21% and 29%. Decrease of LDL-cholesterol has been accompanied by reduction of apo B concentration by 16% resp. 24%. Also triglycerides levels were significantly influenced (-9%). On the other hand treatment with fluvastatin did not affect HDL-cholesterol and apo A-I concentration.

DISCUSSION: Our first results correspond to results of other authors. We also compared results with fluvastatin with our previous studies in which we used lovastatin and simvastatin. From the comparision with other statins we can conclude that the efficacy of fluvastatin is similar to lovastatin and simvastatin. On the other hand we have to notice, that the percent reduction of total and LDL-cholesterol after fluvastatin was a little bit smaller.

CONCLUSIONS: Fluvastatin, Lescol, seems to be a powerful hypolipidemic drug, well tolerated by the patients. In safety laboratory we did not notice any important undesirable result.

Keywords: Adult; Anticholesteremic Agents /therapeutic use/; Fatty Acids, Monounsaturated /therapeutic use/; Female; Fluvastatin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemia, Familial Combined /blood/; Hyperlipoproteinemia Type II /blood/; Hyperlipoproteinemias /blood/; Indoles /therapeutic use/; Male; Middle Aged