title: Favorable effects of ezetimibe alone or in association with simvastatin on the removal from plasma of chylomicrons in coronary heart disease subjects.
abstract: OBJECTIVE
  Reductions on the clearance from plasma of chylomicrons are associated with atherosclerosis. Statins improve the removal from plasma of chylomicrons in a dose dependent manner. There is controversy whether ezetimibe modifies the plasma clearance of chylomicrons. Effects of ezetimibe alone or in combination with simvastatin were compared with low and high dose of the latter, upon the kinetics of a chylomicron-like emulsion in coronary heart disease (CHD) patients.
  
  
  METHODS
  25 CHD patients were randomized for treatment with ezetimibe 10 mg (group 1) or simvastatin 20 mg (group 2) with progression to ezetimibe + simvastatin 10/20 mg or simvastatin 80 mg, respectively. Kinetic studies were performed at baseline and after each treatment period of 6 weeks. The fractional catabolic rates (FCR) of the emulsion labeled with (14)C-CE and (3)H-TG, that represent respectively chylomicron remnant and triglyceride removal, were calculated. Comparisons were made by ANOVA.
  
  
  RESULTS
  The (14)CE-FCR in group 1 were 0.005 ± 0.004, 0.011 ± 0.008 and 0.018 ± 0.005 min(-1) and in group 2 were 0.004 ± 0.003, 0.011 ± 0.008 and 0.019 ± 0.007 min(-1) respectively at baseline, after 6 and 12 weeks (p < 0.05 vs. baseline, and 6 vs. 12 weeks). The (3)H-TG-FCR in group 1 were 0.017 ± 0.011, 0.024 ± 0.011 and 0.042 ± 0.013 min(-1) and in group 2 were 0.016 ± 0.009, 0.022 ± 0.009 and 0.037 ± 0.012 min(-1) at baseline, after 6 and 12 weeks (p < 0.05 vs. baseline, and 6 vs. 12 weeks). There were no differences between groups in time.
  
  
  CONCLUSIONS
  Both treatments increased similarly the removal from plasma of chylomicron and remnants in CHD patients.
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil.
authors: Otavio Celeste
authors: OC
authors: Mangili
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil.
authors: Ana C
authors: AC
authors: Moron Gagliardi
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil.
authors: Leonardo Celeste
authors: LC
authors: Mangili
authors: Instituto de Pesquisas Energéticas e Nucleares, IPEN, Sao Paulo, Brazil.
authors: Carlos H
authors: CH
authors: Mesquita
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil.
authors: Luiz A
authors: LA
authors: Machado Cesar
authors: Kagawa Nutrition University, Tokyo, Japan.
authors: Akira
authors: A
authors: Tanaka
authors: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA, USA.
authors: Ernst J
authors: EJ
authors: Schaefer
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil.
authors: Raul C
authors: RC
authors: Maranhão
authors: Heart Institute (InCor) University of Sao Paulo Medical Scholl Hospital, Sao Paulo, Brazil. Electronic address: raul.santos@incor.usp.br.
authors: Raul D
authors: RD
authors: Santos
mesh_terms: D000368:Aged; D001384:Azetidines / Q000008:administration & dosage*; D002788:Cholesterol Esters / Q000378:metabolism; D053298:Chylomicron Remnants / Q000378:metabolism; D002914:Chylomicrons / Q000097:blood / Q000378:metabolism*; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood; D014304:Triolein / Q000378:metabolism
chemical_list: D001384:Azetidines; D002788:Cholesterol Esters; D053298:Chylomicron Remnants; D002914:Chylomicrons; D014280:Triglycerides; D014304:Triolein; C014409:cholesteryl oleate; D019821:Simvastatin; D000069438:Ezetimibe
keywords: ApoB-48; Chylomicrons; Emulsions; Ezetimibe; Simvastatin; Triglyceride-rich lipoproteins