The effect of simvastatin alone versus simvastatin plus ezetimibe on the concentration of small dense low-density lipoprotein cholesterol in subjects with primary hypercholesterolemia (Journal article)

Florentin, M./ Liberopoulos, E. N./ Moutzouri, E./ Rizos, C. V./ Tselepis, A. D./ Elisaf, M. S.

Objective: To compare the effects of simvastatin alone versus simvastatin plus ezetimibe on small dense low-density lipoprotein cholesterol (sdLDL-C) concentration in subjects with primary hypercholesterolemia. Research design and methods: Patients with LDL-C levels above those recommended by the National Cholesterol Education Program Adult Treatment Panel III were randomized to open-label simvastatin 40 mg (n=50) or simvastatin/ezetimibe 10/10 mg as a fixed combination (n=50) daily. LDL particle size (estimated by electrophoresis), sdLDL-C levels, and lipid profile were blindly assessed at baseline and 3 months. Clinical trial registration: NCT00932620. Results: Both simvastatin 40 mg and simvastatin/ezetimibe 10/10 mg decreased total cholesterol (-31% and -36%, respectively), LDL-C (-43% and -49%, respectively), triglycerides (-17% and -19%, respectively), non-high-density lipoprotein cholesterol (non-HDL-C; -40% and -46%, respectively), large LDL-C (-40 and -44%, respectively) and sdLDL-C levels (-42% and -46%, respectively, all p<0.000 vs baseline) and increased LDL particle size (+0.5% and +0.7%, respectively, both p<0.05 vs baseline). The changes in total cholesterol, LDL-C and non-HDL-C were greater in the simvastatin/ezetimibe group (all p<0.05). Changes in triglycerides, large LDL-C, sdLDL-C levels and LDL particle size were similar in the two groups. In multivariate analysis, baseline sdLDL-C and triglyceride levels, but not the choice of treatment, were significantly and independently correlated with the changes in sdLDL-C levels. Conclusion: The combination of simvastatin 10 mg plus ezetimibe 10 mg is similarly effective to simvastatin 40 mg in improving sdLDL-C concentration and LDL particle size in subjects with primary hypercholesterolemia.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας
Keywords: ezetimibe,low density lipoprotein particle size,simvastatin,small dense low density lipoprotein,intima-media thickness,c-reactive protein,ldl subfraction distribution,metabolic syndrome,familial hypercholesterolemia,randomized-trial,statin therapy,b metabolism,atorvastatin,ezetimibe/simvastatin
ISSN: 0300-7995
Link: <Go to ISI>://000287322500021
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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