Print this pageThe Impact of Statin Therapy on Lipoprotein Levels in the Plasma and Mature Carotid Artery Plaques
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Gilbert Aidinian, MD1, Christopher Abularrage, MD2, Paul W. White, MD1, Dewight Kellicut, MD1, Niten Singh, MD3, Philippe Marmillot, PhD3, M.Raj Lakshman, PhD3, Jonathan M. Weiswasser, MD4, Anton N. Sidawy, MD3, Arora Subodh, MD5.
1Walter Reed Army Medical Center, Washington, DC, USA, 2Georgetown University, Washington, DC, USA, 3Veterans Affairs Hospital, Washington, DC, USA, 4Vaterans Affairs Hospital, Washington, DC, USA, 5George Washington University, Washington, DC, USA.
OBJECTIVES: Carotid artery atherosclerosis is associated with significant morbidity and mortality from cerebrovascular thromboembolism. There is a strong positive relationship between serum lipoprotein concentrations and atherosclerosis. The intention of this study was to assess the effect of stain therapy on plasma and carotid artery plaque lipoprotein levels.
METHODS: Plasma samples and carotid artery plaques were obtained from 23 patients (13 asymptomatic and 10 symptomatic patients) undergoing carotid endarterectomy. Total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), and oxLDL (oxidized low density lipoprotein) were extracted from plaques and quantified using colorimetric and enzyme immunoassay ELISA. Serum samples were quantified in a similar manner. Demographic data were obtained from hospital records. Data was analyzed using SPSS (Chicago, IL).
RESULTS: There was a moderate correlation between the serum and plaque oxLDL levels in the entire group of patients (Spearman’s coefficient, 0.54; P=.01). Plaque LDL was higher in the symptomatic group compared to the asymptomatic group (mean ± sd, 44.5 ± 10.7 vs. 37.8 ± 5.4 mg/dL; P=.02). Although there was no difference in serum lipids between group of patients on statins with those not on this therapy, patients on statins had higher levels of all plaque lipid levels (Table).
| Plaque Lipoprotein | Statin Therapy | P - value | |
| Yes (n = 16) | No (n = 7) | ||
| Cholesterol (mg/dL) | 35.5 ± 11.9 | 23.9 ± 4.4 | .01 |
| Triglyceride (mg/dL) | 46.5 ± 7.0 | 39.7 ± 3.2 | .02 |
| HDL (mg/dL) | 17.9 ± 2.6 | 15.7 ± .82 | .02 |
| LDL (mg/dL) | 42.9 ± 9.3 | 35.8 ± 3.9 | .04 |
| oxLDL (U/L) | .17 ± .14 | .05 ± .05 | .02 |
CONCLUSIONS: Our results demonstrate that plasma levels of oxLDL correlate with plaque levels of oxLDL. High plaque LDL levels may increase the risk of symptomatic carotid disease. Although statin therapy decreased the serum lipoprotein levels, it did not decrease their levels in established plaques. Earlier treatment of elevated plasma lipids before a complex plaque is established, especially oxLDL, may have a positive impact on carotid artery disease.
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