Pleiotropic effects of ezetimibe/simvastatin vs. high dose simvastatin

被引：43

作者：

Pesaro, Antonio Eduardo P. ^{[1
]}

Serrano, Carlos V., Jr. ^{[1
]}

Fernandes, Juliano L. ^{[1
]}

Cavalcanti, Alexandre B. ^{[2
]}

Campos, Alexandre H. ^{[3
]}

Martins, Herlon S. ^{[4
]}

Maranhao, Raul C. ^{[1
]}

de Lemos, James A. ^{[5
]}

Souza, Heraldo P. ^{[4
]}

Nicolau, Jose C. ^{[1
]}

机构：

[1] Univ Sao Paulo, Inst Heart, BR-05403901 Sao Paulo, Brazil

[2] Hosp Coracao HCor, Res Inst, HCor Cardiac Hosp Hosp Coracao, BR-04005000 Sao Paulo, Brazil

[3] Albert Einstein Hosp, Sao Paulo, SP, Brazil

[4] Univ Sao Paulo, Clin Hosp, BR-05403000 Sao Paulo, Brazil

[5] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2012年 / 158卷 / 03期

基金：

巴西圣保罗研究基金会;

关键词：

Coronary artery disease; Cholesterol; Inflammation; Platelet function; Statins; CORONARY-ARTERY-DISEASE; LOW-DENSITY-LIPOPROTEIN; C-REACTIVE PROTEIN; PLATELET-FUNCTION; STATIN THERAPY; CHOLESTEROL; ATORVASTATIN; EZETIMIBE; MEMBRANE; ASPIRIN;

D O I：

10.1016/j.ijcard.2011.01.062

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 4x less of simvastatin, E10/S20 induced a greater platelet inhibitory effect than S80. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

引用

页码：400 / 404

页数：5