title: Differences in action of atorvastatin and ezetimibe in lowering low-density lipoprotein cholesterol and effect on endothelial function: randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to compare the effect on endothelial function of increasing statin dose to add-on ezetimibe in patients with coronary artery disease (CAD) already treated with statin.
  
  
  RESULTS
  Two-hundred and forty-three patients with CAD and low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dl even after treatment with atorvastatin (10 mg) were prospectively randomized to the ezetimibe addition (10mg) group (A10E10; n=117) or to the double atorvastatin dose (to 20 mg; A20; n=133) group for 12 weeks. Primary endpoint was change in endothelial function measured by logarithmic-scale reactive hyperemia index (L_RHI). After treatment, high-sensitivity C-reactive protein (hs-CRP) and all lipids except triglyceride and high-density lipoprotein cholesterol were significantly reduced in both groups. The mean percent changes in LDL-C for the A10E10 and A20 groups were -25.8% and -9.1%, respectively (P<0.001). L_RHI increased from 0.47 to 0.62 in the A20 group (P<0.001), but not in the A10E10 group (from 0.45 to 0.48, P=0.399). Absolute change in L_RHI was significantly higher in the A20 than A10E10 group (0.02±0.29 vs. 0.16±0.27, P<0.001).
  
  
  CONCLUSIONS
  Statin and ezetimibe have different effects on endothelial function independent from LDL-C-lowering effects.
authors.affiliation: Department of Cardiology, Kameda Medical Center, Kamogawa, Japan. yuya8950@gmail.com
authors.forename: Yuya
authors.initials: Y
authors.lastname: Matsue
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000069059:Atorvastatin; D001384:Azetidines / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000378:metabolism*; D000069438:Ezetimibe; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D014280:Triglycerides; D002097:C-Reactive Protein; D000069059:Atorvastatin; D000069438:Ezetimibe