TY - JOUR
T1 - Pleiotropic effects of ezetimibe/simvastatin vs. high dose simvastatin
AU - Pesaro, Antonio Eduardo P
AU - Serrano, Carlos V.
AU - Fernandes, Juliano L.
AU - Cavalcanti, Alexandre B.
AU - Campos, Alexandre H.
AU - Martins, Herlon S.
AU - Maranhão, Raul C.
AU - de Lemos, James A
AU - Souza, Heraldo P.
AU - Nicolau, José C.
N1 - Funding Information:
We gratefully thank Dr Renato D Lopes for his writing expertise. This work was supported by grants from the São Paulo Research Foundation ( FAPESP/05/57710-3 ). No industry support was provided for this study.
PY - 2012/7/26
Y1 - 2012/7/26
N2 - Background: In the setting of stable coronary artery disease (CAD), it is not known if the pleiotropic effects of cholesterol reduction differ between combined ezetimibe/simvastatin and high-dose simvastatin alone. Objective: We sought to compare the anti-inflammatory and antiplatelet effects of ezetimibe 10 mg/simvastatin 20 mg (E10/S20) with simvastatin 80 mg (S80). Methods and results: CAD patients (n = 83, 63 ± 9 years, 57% men) receiving S20, were randomly allocated to receive E10/S20 or S80, for 6 weeks. Lipids, inflammatory markers (C-reactive protein, interleukin-6, monocyte chemoattractant protein-1, soluble CD40 ligand and oxidized LDL), and platelet aggregation (platelet function analyzer [PFA]-100) changes were determined. Baseline lipids, inflammatory markers and PFA-100 were similar between groups. After treatment, E10/S20 and S80 patients presented, respectively: (1) similar reduction in LDL-C (29 ± 13% vs. 28 ± 30%, p = 0.46), apo-B (18 ± 17% vs. 22 ± 15%, p = 0.22) and oxidized LDL (15 ± 33% vs. 18 ± 47%, p = 0.30); (2) no changes in inflammatory markers; and, (3) a higher increase of the PFA-100 with E10/S20 than with S80 (27 ± 43% vs. 8 ± 33%, p = 0.02). Conclusions: These data suggest that among stable CAD patients treated with S20, (1) both E10/S20 and S80 were equally effective in further reducing LDL-C; (2) neither treatment had any further significant anti-inflammatory effects; and (3) E10/S20 was more effective than S80 in inhibiting platelet aggregation. Thus, despite similar lipid lowering and doses 4× less of simvastatin, E10/S20 induced a greater platelet inhibitory effect than S80.
AB - Background: In the setting of stable coronary artery disease (CAD), it is not known if the pleiotropic effects of cholesterol reduction differ between combined ezetimibe/simvastatin and high-dose simvastatin alone. Objective: We sought to compare the anti-inflammatory and antiplatelet effects of ezetimibe 10 mg/simvastatin 20 mg (E10/S20) with simvastatin 80 mg (S80). Methods and results: CAD patients (n = 83, 63 ± 9 years, 57% men) receiving S20, were randomly allocated to receive E10/S20 or S80, for 6 weeks. Lipids, inflammatory markers (C-reactive protein, interleukin-6, monocyte chemoattractant protein-1, soluble CD40 ligand and oxidized LDL), and platelet aggregation (platelet function analyzer [PFA]-100) changes were determined. Baseline lipids, inflammatory markers and PFA-100 were similar between groups. After treatment, E10/S20 and S80 patients presented, respectively: (1) similar reduction in LDL-C (29 ± 13% vs. 28 ± 30%, p = 0.46), apo-B (18 ± 17% vs. 22 ± 15%, p = 0.22) and oxidized LDL (15 ± 33% vs. 18 ± 47%, p = 0.30); (2) no changes in inflammatory markers; and, (3) a higher increase of the PFA-100 with E10/S20 than with S80 (27 ± 43% vs. 8 ± 33%, p = 0.02). Conclusions: These data suggest that among stable CAD patients treated with S20, (1) both E10/S20 and S80 were equally effective in further reducing LDL-C; (2) neither treatment had any further significant anti-inflammatory effects; and (3) E10/S20 was more effective than S80 in inhibiting platelet aggregation. Thus, despite similar lipid lowering and doses 4× less of simvastatin, E10/S20 induced a greater platelet inhibitory effect than S80.
KW - Cholesterol
KW - Coronary artery disease
KW - Inflammation
KW - Platelet function
KW - Statins
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U2 - 10.1016/j.ijcard.2011.01.062
DO - 10.1016/j.ijcard.2011.01.062
M3 - Article
C2 - 21334753
AN - SCOPUS:84863633158
SN - 0167-5273
VL - 158
SP - 400
EP - 404
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -