Effect of ezetimibe monotherapy on the concentration of lipoprotein subfractions in patients with primary dyslipidaemia.
BACKGROUND
Recent studies suggest that the distribution of lipoprotein subfractions is an independent predictor of vascular events. Therefore, we evaluated the effect of ezetimibe (a selective cholesterol transport inhibitor) on the concentrations of lipoprotein subfractions in patients with primary dyslipidaemia.


METHODS
Patients (n = 50) with primary dyslipidaemias were recruited. The concentrations of the individual lipoprotein subfractions were measured using the Lipoprint system at baseline and after 16 weeks of treatment.


RESULTS
Ezetimibe reduced total, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (HDL-C) values as well as apolipoprotein B concentrations. Subfractionation of apolipoprotein B-containing lipoproteins showed that the reduction in LDL-C values was due to a fall in the concentrations of all LDL subfractions. However, a more pronounced trend towards a decrease in the concentrations of dense LDL subfractions was observed. Patients with triglyceride values >1.7 mmol/L had significantly greater reductions in the concentrations of small, dense LDL particles compared with those with normal triglyceride levels (49 vs. 19%, respectively; p < 0.05). Ezetimibe decreased the concentrations of HDL-C mainly due to a fall in the concentration of dense HDL subfractions.


CONCLUSIONS
Ezetimibe can favourably affect the distribution of LDL subfractions, especially in patients with elevated triglyceride values. Further studies are needed to clarify the significance of the ezetimibe-induced reduction in the concentrations of dense HDL particles.
Kalogirou
Mihalis
M
Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Tsimihodimos
Vasilis
V
Gazi
Irene
I
Filippatos
Theodosios
T
Saougos
Vasilis
V
Tselepis
Alexandros D
AD
Mikhailidis
Dimitri P
DP
Elisaf
Moses
M
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001384:Azetidines / Q000627:therapeutic use*; D050171:Dyslipidemias / Q000097:blood* / Q000188:drug therapy*; D000069438:Ezetimibe; D006801:Humans; D008074:Lipoproteins / Q000097:blood* / Q000737:chemistry* / Q000145:classification; D008875:Middle Aged; D009994:Osmolar Concentration; D010316:Particle Size
D000924:Anticholesteremic Agents; D001384:Azetidines; D008074:Lipoproteins; D000069438:Ezetimibe