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Pleiotropic effects of ezetimibe/simvastatin vs. high dose simvastatin
International Journal of Cardiology, 07/16/2012
Clinical Article
Pesaro AEP et al. – These data suggest that among stable coronary artery disease (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.
Methods- CAD patients (n=83, 63±9years, 57% men) receiving S20, were randomly allocated to receive E10/S20 or S80, for 6weeks.
- 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:
- 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);
- No changes in inflammatory markers;
- And, a higher increase of the PFA–100 with E10/S20 than with S80 (27±43% vs. 8±33%, p=0.02).
