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DOI: 10.1055/s-2001-10347
Cholesterinstoffwechselstörung
Publication History
Publication Date:
31 December 2001 (online)
![](https://www.thieme-connect.de/media/dmw/200103/lookinside/thumbnails/10.1055-s-2001-10347-1.jpg)
Frage: Bei einem jetzt 39-jährigen Patienten wurde die Indikation für eine lebenslange Therapie mit Atorvastatin in einer Dosis von 80 mg/d gestellt.
- Sollte Q10 zusätzlich gegeben werden? Wenn ja, in welcher Dosierung?
- Ist die Gabe von Vitamin E und Acetylsalicylsäure begründet?
Antwort: Bei dem beschriebenen Patienten liegen mehrere Risikofaktoren für die Entwicklung einer koronaren Herzkrankheit (KHK) vor: positive Familienanamnese, sehr hohes LDL-Cholesterin (240 mg/dl), niedriges HDL-Cholesterin (25 mg/dl), hohe Triglyzeride (500 mg/dl, die ein VLDL-Cholesterin von ca. 55 mg/dl bedingen).
Literatur
- 1 Scandinavian Simwastatin Survival Study Group . Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). Lancet. 1994; 344 1383-1389
- 2 Sacks F M, Pfeffer M A, Moye L A, rouleau J L, Rutherford J D, Cole T G, Brown L, Warnica J W, Arnold J MO, Wun C C, Davis B R, Braunwald E. for the Cholesterol and Recurrent Events Trial Investigators . The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996; 335 1001-1109
- 3 The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group . Prevention of cardiovascular events and death with pravastatin in patients with coronary heard disease and a broad range of initial cholesterol levels. N Engl J Med. 1998; 339 1349-1357
- 4 Shepherd J, Cobbe S M, Ford I, Isles C G, Lorimer A R, Macfarlane P W, MkKillop J H, Packard C J. for the West of Scotland Coronary prevention study Group . Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995; 333 1301-1307
- 5 Burkhard-Meier C, Deutsch H J, Erdmann E. Aktuelle Therapie der instabilen Angina pectoris. Dtsch med Wschr. 1999; 124 733-739
- 6 Pitt B, Waters D, Brown W V, van Boven A J, Schwartz L, Title L M, Eisenberg D, Shurzinske L, McCormick L S. for the Atorvastatin versus Revascularization Treatment Investigators . Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. N Engl J Med. 1999; 341 70-76
- 7 Ghirlanda G, Oradei A, Manto A, Lippa S, Uccioli L, Caputo S, Greco A V, Litarru G P. Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: A double-blind, placebo-controlled study. J Clin Pharmacol. 1993; 33 226-229
- 8 Watts G F, Castelluccio C, Rice-Evans C, Taub N A, Baum H, Quinn P J. Plasma coenzyme Q (ubiquinone) concentrations in patients treated with simvastatin. J Clin Pathol. 1993; 46 1055-1057
- 9 De Pinieux G, Chariot P, Ammi-Said M, Louarn F, Lejonc J L, Astier A, Jacotot B, Cherardi R. Lipid-lowering drugs and mitochondrial function: Effects of HMG-CoA reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio. Brit J Clin Pharmacol. 1996; 42 333-337
- 10 Human J A, Ubbink J B, Jerling J J, Delport R, Vermaak W J, Vorster H H, Lagendijk J, Potgieter H C. The effect of Simvastatin on the plasma antioxidant concentrations in patients with hypercholesterolaemia. Clin Chim Acta. 1997; 263 67-77
- 11 Mortensen S A, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Asp Med. 1997; 18 (Suppl.) S137-144
- 12 Steering committee of the Physician’s Health Study Research Group . Final report on the aspirin component of the ongoing Physician’s Health Study. N Engl J Med. 1989; 296 313-316
- 13 Stephens N G, Parsons A, Schofield P M, Kelly F, Cheeseman K, Mitchinson M J. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996; 347 781-786
- 14 Peto R, Gray R, Collins R, Wheatley K, Hennekens C, Jamrozik K, Warlow C, Hafner B, Thomson E, Norton S. et al . Randomised trial of prophylactic daily aspirin in British male doctors. Brit Med J. 1988; 296 313-316
Prof. Dr. Dr. Hanns-Ulrich Marschall
Karolinska Institutet Dept. of Medicine Div. of Gastroenterology and Hepatology Huddinge University Hospital K63
14 86 Stockholm
Schweden
Email: hanns-ulrich.marschall@mbb.ki.se