title: Dyslipidemic drugs in metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome predisposes to diabetes and atherosclerotic vascular disease. Statins reduce cardiovascular events, so all metabolic syndrome patients should be evaluated for dyslipidemia. Many patients fail to achieve lipid goals with statin monotherapy. Co-administration of ezetimibe (EZE) and atorvastatin (ATV) may enable more patients to achievelow-density lipoproteincholesterol (LDL-C) goal while avoiding risks of high-dose statin monotherapy.
  
  
  METHODS
  The present study compares rosuvastatin (Rsv) with a combination of (Atv) and (Eze). Metabolic syndrome patients, 30-70 years with LDL-C ≥130 mg/dl and a 10-year CHD risk score of 10% were randomized to double-blind treatment with (Rsv) 5 mg (n = 67) or (Atv) 10 mg+(Eze) 10 mg (n = 68) for 12 weeks.
  
  
  RESULTS
  LDL-C reduced significantly; (32.3% and 30.3%, P < 0.001) in (Atv)+(Eze) and (Rsv), respectively, but there was no significant difference between two arms. More patients achieved LDL-C goal of ≤100 mg/dl with (Atv)+(Eze) compared to (Rsv) (65% vs. 58%, P < 0.05). Triglycerides (TG) were reduced more with (Atv)+(Eze) compared to (Rsv) (28.1% and 21.4%, P < 0.001). Greater increase in high-density lipoprotein cholesterol (HDL-C) was observed with (Atv)+(Eze). Both treatments were well tolerated.
  
  
  CONCLUSIONS
  This study shows that the combination of (Atv)+(Eze) has more efficacy and comparable safety to that of (Rsv).
authors.affiliation: Rajiv Gandhi Center for Diabetes and Endocrinology, JNMCH, Aligarh, India.
authors.forename: Sheelu S
authors.initials: SS
authors.lastname: Siddiqi
authors.lastname: Misbahuddin
authors.forename: Farida
authors.initials: F
authors.lastname: Ahmad
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Rahman
authors.forename: Asad U
authors.initials: AU
authors.lastname: Khan
keywords: 3-hydroxy-3-methyglutaryl-CoA; insulin resistance syndrome; low-density lipoproteincholesterol; reductase; statins