- 作者：Antonio Hern¨¢ndez-Mijares ; Celia Ba?uls ; Lorena Bellod ; Ana Jover ; Eva Sol¨¢ ; V¨ªctor M. V¨ªctor ; Milagros Rocha
- 关键词：Dislipidemia ; Simvastatina ; Ezetimiba ; Subfracciones lipoproteicas ; Inflamació ; n
- 刊名：Cl¨ªnica e Investigaci¨®n en Arteriosclerosis
- 出版年：2012
- 出版时间：September-October, 2012
- 年：2012
- 卷：24
- 期：5
- 页码：217-225
- 全文大小：350 K
Introduction
Coadministration of drugs is common in the pharmacologic treatment of dyslipidemia, with statins and ezetimibe generally constituting the medication of choice. By acting at different levels, the combination of these drugs allows the therapeutic objective to be achieved. However, it is not known how these drugs qualitatively affect the composition of lipoprotein subfractions, which differ in size and atherogenic potential. We set out to evaluate this effect as well as their anti-inflammatory effects.
Methods
Thirty-nine hyperlipidemic patients were randomly assigned to one of 2 groups: one received simvastatin (40 mg/day) and the other received ezetimibe (10 mg/day) for 4 weeks, after which both groups were administered combined therapy for an additional 4-week period. Lipid profile, lipoprotein subfractions of LDL and HDL, and inflammatory parameters were evaluated.
Results
An improvement was detected in most lipid parameters after administration of hypolipemic drugs as monotherapy. Treatment with simvastatin vs ezetimibe reduced LDLc by 40.2 % vs 19.6 % and non-HDLc by 37.1 % vs 18.8 % , respectively. Coadministration of the two pharmacological agents induced a reduction of LDLc of up to 57 % . Only simvastatin induced alterations in the levels of triglycerides (?18.6 % ) and HDLc (+7.4 % ). Simvastatin also reduced the smaller HDL subfractions and increased the larger ones. In addition, it lowered the percentage of sdLDL and increased the diameter of the LDL particles, and produced a significant reduction in TNF¦Á.
Conclusions
The coadministration of simvastatin and ezetimibe has an additive cholesterol-lowering effect. Furthermore, only simvastatin reduces atherogenic lipoprotein subfractions and exerts anti-inflammatory effects over longer periods of time.