Combined hyperlipidemia in a single subject with tetraplegia: ineffective risk reduction after atorvastatin monotherapy.

Background/objective: Effects of atorvastatin (Lipitor) drug monotherapy (10 mg daily) on fasting blood lipid profiles and cardiovascular disease (CVD) risks were examined for a single subject with C5-C6 tetraplegia. Routine fasting lipid profiles were analyzed by standard biochemistry techniques for total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Lipid profiles were analyzed on 3 occasions before drug therapy was initiated and 3 months after therapy commenced. The TC:HDL and LDL:HDL ratios were computed for all sampling times and used to assess pretreatment and post-treatment CVD risk.

Results: Fasting TC, TG, and LDL-C were all significantly reduced by therapy. The pretreatment HDL-C of 35 mg/dL was lowered to 21 mg/dL. As a result, the TC:HDL risk ratio was only marginally reduced from 6.6 to 6.4, whereas the LDL:HDL risk ratio remained unchanged by treatment.

Conclusions: In this man with tetraplegia, atorvastatin drug monotherapy rapidly lowered TC, TG, LDL-C, and HDL-C. However, the TC:HDL ratio, considered the best predictor of CVD risk, was unchanged.