Effect of atorvastatin and rosuvastatin on the PCSK9 blood concentration in statin-naive patients with atherosclerosis

Abstract

Statins are currently the main group of lipid-lowering drugs used in clinical practice. However not all patients manage to achieve ‘target’ levels of LDL. A possible cause is statin-induced increase of expression of hepatocyte PCSK9 which regulates LDL uptake.Aim. The aim of the study was to determine whether the changes of parameters of lipid spectrum depend on the changes of PCSK9 concentration in blood during treatment with rosuvastatin or atorvastatin.Material and methods. 20 patients (9 men), median age 63 (57;72) years referred for the examination at NMRCC with coronary and carotid atherosclerosis and with the indications for statin therapy were included. In 9 patients the therapy with atorvastatin (40-80 mg/day) was initiated. 11 patients started taking rosuvastatin (10-40 mg/day). The parameters of lipid spectrum, Lp(a) and PCSK9 blood levels were determined at baseline and after 1 month after the initiation of statin therapy.Results. Atorvastatin and rosuvastatin intake were accompanied by the decrease in the levels of total cholesterol, triglycerides, LDL. The level of Lp(a) did not change. In patients receiving rosuvastatin a significant increase in the PCSK9 serum concentration was achieved while atorvastatin therapy was associated with much less pronounced and not statistically significant increase in PCSK9 levels.Conclusion. We suggest that the lipid-lowering activity of statins does not depend on their effect on PCSK9 expression. The limitation of this study is the small sample size and short observation time.

Keywords

• statins, pcsk9, atherosclerosis