title: Comparison of the effect of simvastatin versus simvastatin/ezetimibe versus rosuvastatin on markers of inflammation and oxidative stress in subjects with hypercholesterolemia.
abstract: OBJECTIVE
  Statins may exhibit anti-inflammatory and antioxidant effects. Whether different statins at equivalent doses or the combination of low-dose statin with ezetimibe have comparable anti-inflammatory and antioxidant effects is unknown. The aim of this study was to compare the effects of simvastatin, simvastatin/ezetimibe or rosuvastatin at equivalent low-density lipoprotein cholesterol lowering doses on inflammation and oxidative stress indices in subjects with hypercholesterolemia.
  
  
  METHODS
  This was a pre-specified analysis of a prospective, randomized, open-label, blinded endpoint (PROBE) study. We enrolled one hundred and fifty three (n = 153) hypercholesterolemic subjects who were randomized to receive simvastatin 40 mg or simvastatin/ezetimibe 10/10 mg or rosuvastatin 10 mg daily. Plasma 8-Epi prostaglandin F2 alpha (8-epiPGF2a), oxidized LDL (oxLDL) and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and mass were measured at baseline and following 12 weeks of treatment.
  
  
  RESULTS
  A significant reduction in plasma 8-isoprostane and oxLDL levels was observed in all treatment groups [by 10%, 8% and 6% (p < 0.05 compared with baseline) and 41%, 40% and 39% (p < 0.001 compared with baseline) in simvastatin, simvastatin/ezetimibe and rosuvastatin groups, respectively]. In all treatment groups a significant reduction in total plasma Lp-PLA2 activity and mass was observed (by 36%, 31% and 38% and 36%, 32% and 32% for simvastatin, simvastatin/ezetimibe and rosuvastatin, respectively, p < 0.001 compared with baseline). No intergroup differences were observed.
  
  
  CONCLUSIONS
  Simvastatin 40 mg, simvastatin/ezetimibe 10/10 mg and rosuvastatin 10 mg significantly reduced 8-epiPGF2a, oxLDL and Lp-PLA2 activity and mass to a similar extent.
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, 45 110 Ioannina, Greece.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Moutzouri
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Liberopoulos
authors.forename: Constantinos C
authors.initials: CC
authors.lastname: Tellis
authors.forename: Haralambos J
authors.initials: HJ
authors.lastname: Milionis
authors.forename: Alexandros D
authors.initials: AD
authors.lastname: Tselepis
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood; D000328:Adult; D000368:Aged; D001384:Azetidines / Q000008:administration & dosage / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D004338:Drug Combinations; D000069438:Ezetimibe; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D011743:Pyrimidines / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D001384:Azetidines; D008078:Cholesterol, LDL; D004338:Drug Combinations; D005464:Fluorobenzenes; D008077:Lipoproteins, LDL; D011743:Pyrimidines; D013449:Sulfonamides; C099252:oxidized low density lipoprotein; C075750:8-epi-prostaglandin F2alpha; D000068718:Rosuvastatin Calcium; D019821:Simvastatin; D015237:Dinoprost; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000069438:Ezetimibe
keywords: Ezetimibe; Inflammation; Isoprostanes; Lipoprotein associated phospholipase A2; Oxidative stress; Oxidized LDL; Rosuvastatin; Simvastatin