Efficacy of simvastatin or ezetimibe on tissue factor, von Willebrand's factor and C-reactive protein in patients with hypercholesterolaemia.
BACKGROUND
Statins have favourable effects on lipid profiles, decrease total mortality and have many pleiotropic effects.


OBJECTIVE
To determine and compare the pleiotropic effects of simvastatin and ezetimibe in dyslipidaemic patients.


METHODS
Forty-four patients (20 postmenopausal women) with low-density lipoprotein cholesterol >130 mg/dL (or >100mg/dL in patients with coronary artery disease or its equivalent) were treated with simvastatin 10mg daily (n = 21) or ezetimibe 10mg daily (n = 23). In blood samples taken before and three months after treatment, we measured the concentration of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B, lipoprotein(a), homocysteine, tissue factor, von Willebrand's factor and C-reactive protein.


RESULTS
Baseline lipid profiles and haematological variables were similar in both groups. Simvastatin and ezetimibe decreased the concentrations of total cholesterol (262 to 189 mg/dL, p < 0.001, and 268 to 220 mg/dL, p = 0.001, respectively), low-density lipoprotein cholesterol (177 to 114 mg/dL, p < 0.001 and 196 to 146 mg/dL, p < 0.001, respectively) and C-reactive protein (1.2 to 0.3 mg/dL, p = 0.001 and 2.8 to 0.8 mg/dL, p = 0.005, respectively). Simvastatin also reduced the concentration of apolipoprotein B (125 to 93 mg/dL, p < 0.001).


CONCLUSIONS
Both drugs improved lipid profiles and C-reactive protein concentration. However, no influence was found on tissue factor or von Willebrand's factor. Our results suggest that C-reactive protein lowering may occur in conjunction with low-density-lipoprotein cholesterol lowering and not through a specific statin pleiotropic anti-inflammatory effect.
1(st) Cardiology Department, Onassis Cardiac Surgery Centre, 356, Sygrou Ave, 17674 Athens, Greece.
Peggy
P
Kostakou
Genovefa
G
Kolovou
Katherine
K
Anagnostopoulou
Theodor
T
Theodoridis
Vassiliki
V
Galea
Constantinos
C
Mihas
Vassiliki
V
Christopoulou-Cokkinou
Dennis V
DV
Cokkinos
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000627:therapeutic use*; D013925:Thromboplastin / Q000378:metabolism*; D013997:Time Factors; D016896:Treatment Outcome; D014841:von Willebrand Factor / Q000378:metabolism*
D000924:Anticholesteremic Agents; D001384:Azetidines; D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D014841:von Willebrand Factor; D002097:C-Reactive Protein; D013925:Thromboplastin; D019821:Simvastatin; D000069438:Ezetimibe