Pleiotropic effects of ezetimibe/simvastatin vs. high dose simvastatin


Autoria(s): Pesaro, Antonio Eduardo P.; Serrano Jr., Carlos V.; Fernandes, Juliano L.; Cavalcanti, Alexandre B.; Campos, Alexandre H.; Martins, Herlon S.; Maranhão, Raul Cavalcante; Lemos, James A. de; Souza, Heraldo Possolo de; Nicolau, Jose C.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

05/11/2013

05/11/2013

2012

Resumo

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.

Astra Zeneca

AstraZeneca

Merck/Schering Plough

Merck/Schering Plough

Pfizer

Pfizer

Sao Paulo Research Foundation

Sao Paulo Research Foundation [FAPESP/05/57710-3]

Identificador

INTERNATIONAL JOURNAL OF CARDIOLOGY, CLARE, v. 158, n. 3, pp. 400-404, 46204, 2012

0167-5273

http://www.producao.usp.br/handle/BDPI/41393

10.1016/j.ijcard.2011.01.062

http://dx.doi.org/10.1016/j.ijcard.2011.01.062

Idioma(s)

eng

Publicador

ELSEVIER IRELAND LTD

CLARE

Relação

INTERNATIONAL JOURNAL OF CARDIOLOGY

Direitos

closedAccess

Copyright ELSEVIER IRELAND LTD

Palavras-Chave #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 #CARDIAC & CARDIOVASCULAR SYSTEMS
Tipo

article

original article

publishedVersion