- 作者：Takamitsu Nakamura ; Mitsumasa Hirano ; Yoshinobu Kitta ; Daisuke Fujioka ; Yukio Saito ; Ken-ichi Kawabata ; Jun-ei Obata ; Yosuke Watanabe ; Kazuhiro Watanabe ; Kiyotaka Kugiyama
- 关键词：Anti-dyslipidemic agents ; Cholesterol-lowering drugs ; Endothelium ; Hyperlipoproteinemia ; Vasodilation
- 刊名：Journal of Cardiology
- 出版年：2012
- 出版时间：July, 2012
- 年：2012
- 卷：60
- 期：1
- 页码：12-17
- 全文大小：196 K
Summary
Background and purpose
It remains undetermined whether the addition of ezetimibe to ongoing statin therapy is more effective than increasing the dose of statin for reducing remnant lipoprotein levels in patients with remnant lipoproteinemia on previous statin treatment. This study examined whether combined ezetimibe and statin therapy resulted in a greater improvement in remnant lipoprotein levels and endothelial function than with the dose of statin in patients with remnant lipoproteinemia on previous statin treatment.Methods and results
A total of 63 patients with stable coronary artery disease and high levels of remnant-like lipoprotein particle cholesterol (RLP-C) (¡Ý5.0 mg/dL) on statin treatment were assigned randomly to two groups and treated with either addition of ezetimibe (10 mg/day, n = 32) or doubling of statin dose (n = 31). The lipid profiles and flow-mediated dilation (FMD) of the brachial artery were measured at enrollment and after 6 months of treatment. Statin and ezetimibe combined therapy reduced RLP-C and improved FMD to a greater extent than doubling the statin dose ( % reduction in RLP-C, 48 ¡À 18 % vs. 33 ¡À 24 % , respectively, p = 0.01; % improvement in FMD, 47 ¡À 48 % vs. 24 ¡À 23 % , respectively, p = 0.02).
Conclusions
The addition of ezetimibe to ongoing statin treatment reduced RLP-C levels and improved endothelial dysfunction to a greater extent than doubling the statin dose in patients with high RLP-C levels on previous statin treatment. The present results are preliminary and should be confirmed by further studies on a larger number of study patients.