Pleiotropic Effects With Equivalent Low-density Lipoprotein Cholesterol Reduction: Comparative Study Between Simvastatin and Simvastatin/Ezetimibe Coadministration

Araújo, Daniel Branco de; Bertolami, Marcelo Chiara; Ferreira, Waldinai Pereira; Abdalla, Dulcinéia Saes Parra; Faludi, André Árpád; Nakamura, Yara; Bricharello, Liliana P

doi:10.1097/fjc.0b013e3181bfb1a2

Cited by 28 publications

(15 citation statements)

References 33 publications

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“…These results are in agreement with recent studies showing that co-administration of ezetimibe with statins provides an additional improvement in serum LDL-C and overall lipid profile in patients with inadequate lipid control while on statin monotherapy [14–19]. Furthermore, recent reports indicate that ezetimibe exerts pleiotropic effects on cardiovascular function which are similar [26] or improved [27, 28] compared to statin monotherapy, while additional trials are ongoing which will further analyze the impact of ezetimibe on these effects [29, 30]. …”

Section: Discussionsupporting

confidence: 91%

Effectiveness of Ezetimibe in Reducing the Estimated Risk for Fatal Cardiovascular Events in Hypercholesterolaemic Patients with Inadequate Lipid Control While on Statin Monotherapy as Measured by the SCORE Model

Sampalis

Bissonnette

Boukas

2011

Advances in Preventive Medicine

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Objectives. The aim of this prospective cohort, multicentre study was to assess the effect of coadministrating ezetimibe 10 mg/day with an ongoing statin on the estimated risk for Cardiovascular (CVD) mortality in patients with persistently elevated LDL-C after statin monotherapy. Methods. The Systematic Coronary Risk Evaluation (SCORE) function was used to estimate the 10-year risk for cardiovascular mortality at baseline and 6 weeks. Primary outcome measures were absolute and percent changes in estimated Coronary Heart Disease (CHD) Mortality Risk, and general CVD Mortality Risk (Total CVD Mortality Risk). Results. 825 patients were included in the analysis. Mean (SD) age was 62 (10.5) years and 62.3% were males. The mean (SD) estimated Total CVD Mortality Risk decreased from 0.068 (0.059) at baseline to 0.053 (0.046) at 6 weeks (RR = 0.77; 95% CI:0.689–0.867), while the estimated CHD Mortality Risk decreased from 0.047 (0.040) at baseline to 0.034 (0.029) at 6 weeks (RR = 0.72; 95% CI:0.624–0.826). Conclusions. Co-administration of ezetimibe with a statin is effective in significantly reducing the estimated risk for cardiovascular mortality as measured by the SCORE model.

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Section: Discussionsupporting

confidence: 91%

Effectiveness of Ezetimibe in Reducing the Estimated Risk for Fatal Cardiovascular Events in Hypercholesterolaemic Patients with Inadequate Lipid Control While on Statin Monotherapy as Measured by the SCORE Model

Sampalis

Bissonnette

Boukas

2011

Advances in Preventive Medicine

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“…Results were found to be inconstant: six studies found no difference in endothelial function (89,91,94,(96)(97)(98), four found statin alone be better (77,(92)(93)(94), and one study found a beneficial effect of combination therapy over statin alone (90). However, in many of these studies comparing statins vs combination therapy, markedly different lipid lowering effects were found, thus making comparisons difficult (77,(89)(90)(91)94). Two cross-over studies with a reduced risk of confounding and bias, reached discordant conclusions, one showing an improved endothelial function on statin alone (93), and the other not observing any significant difference between the two treatments (97).…”

Section: Ezetimibementioning

confidence: 96%

“…A number of studies have investigated statin therapy versus statins in combination with ezetimibe on endothelial function as a measure of vascular inflammation (77,(89)(90)(91)(92)(93)(94)(95)(96). Results were found to be inconstant: six studies found no difference in endothelial function (89,91,94,(96)(97)(98), four found statin alone be better (77,(92)(93)(94), and one study found a beneficial effect of combination therapy over statin alone (90). However, in many of these studies comparing statins vs combination therapy, markedly different lipid lowering effects were found, thus making comparisons difficult (77,(89)(90)(91)94).…”

Section: Ezetimibementioning

confidence: 99%

Lipid lowering drugs and inflammatory changes: an impact on cardiovascular outcomes?

et al. 2018

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Inflammatory changes are responsible for maintenance of the atherosclerotic process and may underlie some of the most feared vascular complications. Among the multiple mechanisms of inflammation, the arterial deposition of lipids and particularly of cholesterol crystals is the one responsible for the activation of inflammasome NLRP3, followed by the rise of circulating markers, mainly C-reactive protein (CRP). Elevation of lipoproteins, LDL but also VLDL and remnants, associates with increased inflammatory changes and coronary risk. Lipid lowering medications can reduce cholesterolemia and CRP: patients with elevations of both are at greatest cardiovascular (CV) risk and receive maximum benefit from therapy. Evaluation of the major drug series indicates that statins exert the largest LDL and CRP reduction, accompanied by reduced CV events. Other drugs, mainly active on the triglyceride/HDL axis, for example, PPAR agonists, may improve CRP and the lipid pattern, especially in patients with metabolic syndrome. PCSK9 antagonists, the newest most potent medications, do not induce significant changes in inflammatory markers, but patients with the highest baseline CRP levels show the best CV risk reduction. Parallel evaluation of lipids and inflammatory changes clearly indicates a significant link, both guiding to patients at highest risk, and to the best pharmacological approach. Key messages Lipid lowering agents with "pleiotropic" effects provide a more effective approach to CV prevention In CANTOS study, patients achieving on-treatment hsCRP concentrations ≤2 mg/L had a higher benefit in terms of reduction in major CV events The anti-inflammatory activity of PCSK9 antagonists appears to be of a minimal extent.

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“…Между группами показатели в конце курса не различались. О положи-тельном влиянии комбинации Э + C на функцию эндотелия со-общали и другие исследователи [32,48,49].…”

Section: терапевтический архив 12 2014unclassified

Hypolipidemic and pleiotropic effects of a combination of simvastatin and ezetimibe in patients with different types of hyperlipidemia

Ab¹,

Vv²

2014

Ter. arkh.

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Pleiotropic Effects With Equivalent Low-density Lipoprotein Cholesterol Reduction: Comparative Study Between Simvastatin and Simvastatin/Ezetimibe Coadministration

Abstract: The 2 forms of treatment presented similar pleiotropic effects: improvement in endothelial function and decrease in hs-CRP levels.

Cited by 28 publications

References 33 publications

Effectiveness of Ezetimibe in Reducing the Estimated Risk for Fatal Cardiovascular Events in Hypercholesterolaemic Patients with Inadequate Lipid Control While on Statin Monotherapy as Measured by the SCORE Model

Effectiveness of Ezetimibe in Reducing the Estimated Risk for Fatal Cardiovascular Events in Hypercholesterolaemic Patients with Inadequate Lipid Control While on Statin Monotherapy as Measured by the SCORE Model

Lipid lowering drugs and inflammatory changes: an impact on cardiovascular outcomes?

Hypolipidemic and pleiotropic effects of a combination of simvastatin and ezetimibe in patients with different types of hyperlipidemia

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