The Effects of Statin Monotherapy and Low-Dose Statin/Ezetimibe on Lipoprotein-Associated Phospholipase A2

Authors

  • Sang-Hak Lee MD, PhD,

    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Seok-Min Kang MD, PhD,

    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Sungha Park MD, PhD,

    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Yangsoo Jang MD, PhD,

    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Namsik Chung MD, PhD,

    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Donghoon Choi MD, PhD

    Corresponding author
    1. Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
    • Cardiology Division, Severance Cardiovascular Hospital, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120–752, Republic of Korea
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Abstract

Background

Many of the pleiotropic effects of statins remain to be elucidated.

Hypothesis

Different statin regimens with similar lipid-lowering efficacy may have different effects on biomarkers of atherothrombosis including lipoprotein-associated phospholipase A2 (Lp-PLA2).

Methods

After a 4-week dietary lead-in, 82 hypercholesterolemic patients were randomized to 1 of 2 treatment groups: atorvastatin 20 mg or atorvastatin/ezetimibe 5 mg/5 mg. After 8 weeks of drug treatment, the groups were compared for percent change in lipid parameters, Lp-PLA2, interleukin-6 (IL-6), monocyte chemoattractant protein-1, and fibrinogen.

Results

Low-density lipoprotein cholesterol (LDL-C) lowering was comparable between the 2 groups (−47% ± 11% and −49% ± 7% in the atorvastatin and combination groups, respectively). Although Lp-PLA2 was reduced in both groups, the reduction was greater in the atorvastatin group (−42% and −9% [median], respectively, P = 0.03). Although IL-6 was decreased only in the atorvastatin group, IL-6 changes were not significantly different between the 2 groups. The changes in monocyte chemoattractant protein-1 and fibrinogen were similar in each group.

Conclusions

Atorvastatin monotherapy was stronger at reducing plasma Lp-PLA2 than the low-dose atorvastatin/ezetimibe combination after equivalent LDL-C lowering. This result may provide evidence of potential statin effects beyond the lowering of LDL-C. Copyright © 2011 Wiley Periodicals, Inc.

This study was supported by a grant from the Ministry of Health and Welfare, Republic of Korea (A000385), a grant of the Seoul R&BD Program, Republic of Korea (10526), and a grant of the Korean Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085136). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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