Policosanol Attenuates Statin-Induced Increases in Serum Proprotein Convertase SubtilisinKexin Type 9 When Combined with Atorvastatin

الملخص EN

Objective.

Statin treatment alone has been demonstrated to significantly increase plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels.

The effect of policosanol combined with statin on PCSK9 is unknown.

Methods.

Protocol I: 26 patients with atherosclerosis were randomly assigned to receive either atorvastatin 20 mg/d or policosanol 20 mg/d + atorvastatin 20 mg/d for 8 weeks.

Protocol II: 15 healthy volunteers were randomly assigned to either policosanol 20 mg/d or a control group for 12 weeks.

Serum levels of PCSK9 were determined at day 0 and the end of each protocol.

Results.

Protocol I: atorvastatin 20 mg/d significantly increased serum PCSK9 level by 39.4% (256 ± 84 ng/mL versus 357 ± 101 ng/mL, P = 0.002 ).

However, policosanol 20 mg/d + atorvastatin 20 mg/d increased serum PCSK9 level by only 17.4% without statistical significance (264 ± 60 ng/mL versus 310 ± 86 ng/mL, P = 0.184 ).

Protocol II: there was a trend toward decreasing serum PCSK9 levels in the policosanol group (289 ± 71 ng/mL versus 235 ± 46 ng/mL, P = 0.069 ).

Conclusion.

Policosanol combined with statin attenuated the statin-induced increase in serum PCSK9 levels.

This finding indicates that policosanol might have a modest effect of lowering serum PCSK9 levels.