title: Effect of ezetimibe/simvastatin vs atorvastatin on lowering levels of LDL-C and non-HDL-C, ApoB, and hs-CRP in patients with type 2 diabetes.
abstract: BACKGROUND
  In addition to low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (ApoB), and high-sensitivity C-reactive protein (hs-CRP) are considered predictive for cardiovascular disease in type 2 diabetes mellitus (T2DM) patients.
  
  
  OBJECTIVE
  To assess the proportion of T2DM patients with hypercholesterolemia who attained the optional target level of LDL-C (<70 mg/dL) and additionally non-HDL-C (<100 mg/dL), ApoB (<90 mg/dL), and hs-CRP (<2 mg/L), following treatment with ezetimibe/simvastatin (E/S) vs atorvastatin (A).
  
  
  METHODS
  This post-hoc analysis of a multicenter, randomized, double-blind, 6-week parallel study assessed the proportion of T2DM patients who attained specified LDL-C levels and non-HDL-C, ApoB, and hs-CRP with usual, recommended starting doses of E/S (10/20 mg) vs A (10 or 20 mg) and next highest doses of E/S (10/40 mg) vs A (40 mg) by logistic regression. Baseline triglyceride and hs-CRP effects were also evaluated.
  
  
  RESULTS
  Significantly higher percentages of patients treated with E/S compared to A achieved individual and concurrent target levels of LDL-C (<70 mg/dL), non-HDL-C (<100 mg/dL), and ApoB (<90 mg/dL) at all dose comparisons (P < 0.05 to P < 0.001). Baseline triglyceride levels had no effect on reaching LDL-C levels. Attainment of non-HDL-C (<100 mg/dL), and ApoB (<90 mg/dL) was lower at triglycerides ≥200 mg/dL than <200 mg/dL. Achievement of hs-CRP level (<2 mg/L) was comparable for both treatments. Significantly more patients attained both LDL-C (<70 mg/dL) and hs-CRP (<2 mg/L) at all E/S doses compared to A (P < 0.05 to P < 0.001), regardless of baseline CRP levels.
  
  
  CONCLUSIONS
  E/S provides a therapeutic option to T2DM patients for lowering not only LDL-C, but also non-HDL-C, ApoB, and hs-CRP. These factors may help guide assessment and treatment of cardiovascular disease risk in these patients.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, SUNY Upstate Medical University and VA Medical Center, 750 E. Adams Street, CWB 353, Syracuse, NY 13210, USA.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Goldberg
authors.forename: John R
authors.initials: JR
authors.lastname: Guyton
authors.forename: Theodore
authors.initials: T
authors.lastname: Mazzone
authors.forename: Adam
authors.initials: A
authors.lastname: Polis
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Tomassini
authors.forename: Jianxin
authors.initials: J
authors.lastname: Lin
authors.forename: Arvind
authors.initials: A
authors.lastname: Shah
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tershakovec