title: Clinical usefulness of additional treatment with ezetimibe in patients with coronary artery disease on statin therapy. - From the viewpoint of cholesterol metabolism.-.
abstract: BACKGROUND
  Ezetimibe-plus-statin therapy has been reported to provide greater reduction in low-density lipoprotein cholesterol (LDL-C) level than statin monotherapy. The aim of the present study was to evaluate the relationship between LDL-C lowering effect and baseline cholesterol absorption and synthesis markers in patients with coronary artery disease (CAD).
  
  
  RESULTS
  A total of 171 patients with CAD whose LDL-C level was ≥ 100 mg/dl after treatment with atorvastatin (10mg/day) or rosuvastatin (2.5 mg/day) for 4 weeks were assigned to additionally receive ezetimibe (10mg/day) plus a statin or a double dose of statin for 12 weeks. The decreases in LDL-C (-30.0 ± 15.6 mg/dl vs. -19.2 ± 14.2 mg/dl) and the ratio of campesterol, an absorption marker, to total cholesterol levels (-1.35 ± 0.90 µg/mg vs. 0.33 ± 0.74 µg/mg) were greater in the ezetimibe-plus-statin group (P<0.05, respectively). The decrease in LDL-C level in the ezetimibe-plus-statin group was greatest in patients with baseline levels of higher absorption and lower synthesis markers and smallest in patients with baseline levels of lower absorption and higher synthesis markers (-34.3 ± 15.6 mg/dl vs. -21.5 ± 16.7 mg/dl, P<0.05). The decrease in LDL-C did not differ, irrespective of baseline levels of cholesterol absorption and synthesis markers, in the double-dose statin group, and was similar to that in patients with lower absorption and higher synthesis markers in the ezetimibe-plus-statin group.
  
  
  CONCLUSIONS
  Ezetimibe-plus-statin therapy may be useful for lowering LDL-C level, irrespective of baseline levels of cholesterol absorption and synthesis markers.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Okada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Noriaki
authors.initials: N
authors.lastname: Iwahashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Endo
authors.forename: Hideo
authors.initials: H
authors.lastname: Himeno
authors.forename: Kazuki
authors.initials: K
authors.lastname: Fukui
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Shimizu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iwasawa
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Morita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wada
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Shigemasa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Mochida
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Reimin
authors.initials: R
authors.lastname: Sawada
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents; D000069059:Atorvastatin; D001384:Azetidines / Q000008:administration & dosage*; D002784:Cholesterol / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000187:drug effects; D003324:Coronary Artery Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000069438:Ezetimibe; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage; D006538:Heptanoic Acids / Q000008:administration & dosage; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D002784:Cholesterol; D000069059:Atorvastatin; D000069438:Ezetimibe