Atorvastatin 10mg plus ezetimibe 10mg compared with atorvastatin 20mg: Impact on the lipid profile in Japanese patients with abnormal glucose tolerance and coronary artery disease

Yusuke Uemura, Masato Watarai, Hideki Ishii, Masayoshi Koyasu, Kenji Takemoto, Daiji Yoshikawa, Rei Shibata, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Oxidized low-density lipoprotein (LDL) cholesterol is a sensitive lipid marker for predicting atherosclerosis. Ezetimibe and statins are reported to decrease both LDL cholesterol and oxidized LDL cholesterol. This prospective randomized open-label crossover study compared combination therapy with atorvastatin plus ezetimibe versus high-dose atorvastatin monotherapy. Changes in serum lipids, including malondialdehyde-modified LDL (MDA-LDL) as a representative form of oxidized LDL cholesterol, and glucose metabolism were assessed. Methods and results: The subjects were 39 Japanese patients with coronary artery disease and type 2 diabetes or impaired glucose tolerance who were taking 10mg/day of atorvastatin (30 men and 9 women with a mean age of 67.8 years). They were randomized to a group that first received add-on ezetimibe (10mg/day) or a group that first received atorvastatin monotherapy at a higher dose of 20mg/day. Both treatments were given for 12 weeks each in a crossover fashion. Add-on ezetimibe significantly decreased MDA-LDL (109.0±31.9mg/dl to 87.7±29.4mg/dl, p=0.0009), while up-titration of atorvastatin did not. The decrease with add-on ezetimibe was significantly greater than with up-titration of atorvastatin (p=0.0006). Total cholesterol and LDL cholesterol were significantly decreased by both treatments, but the percent reduction with add-on ezetimibe was significantly greater (p<0.05). High-density lipoprotein cholesterol was significantly increased by both treatments and there was no significant difference between them. The apolipoprotein B/apolipoprotein A-I ratio and remnant-like particle cholesterol were only significantly decreased by add-on ezetimibe. Both treatments caused similar elevation of hemoglobin A 1c. Conclusion: In Japanese patients with type 2 diabetes or impaired glucose tolerance and coronary artery disease, adding ezetimibe (10. mg/day) to atorvastatin (10. mg/day) significantly improved the lipid profile compared with atorvastatin monotherapy at 20. mg/day.

Original languageEnglish
Pages (from-to)50-56
Number of pages7
JournalJournal of cardiology
Volume59
Issue number1
DOIs
Publication statusPublished - 01-2012

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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