| The effect of ezetimibe on peripheral arterial atherosclerosis depends upon statin use at baseline. | |
| | |
MedLine Citation:
|
PMID: 21570685 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Both statins and ezetimibe lower LDL-C, but ezetimibe's effect on atherosclerosis is controversial. We hypothesized that lowering LDL-C cholesterol by adding ezetimibe to statin therapy would regress atherosclerosis measured by magnetic resonance imaging (MRI) in the superficial femoral artery (SFA) in peripheral arterial disease (PAD). METHODS: Atherosclerotic plaque volume was measured in the proximal 15-20 cm of the SFA in 67 PAD patients (age 63 ± 10, ABI 0.69 ± 0.14) at baseline and annually × 2. Statin-naïve patients (n=34) were randomized to simvastatin 40 mg (S, n=16) or simvastatin 40 mg+ezetimibe 10mg (S+E, n=18). Patients already on statins but with LDL-C >80 mg/dl had open-label ezetimibe 10mg added (E, n=33). Repeated measures models estimated changes in plaque parameters over time and between-group differences. RESULTS: LDL-C was lower at year 1 in S+E (67 ± 7 mg/dl) than S (91 ± 8 mg/dl, p<0.05), but similar at year 2 (68 ± 10 mg/dl vs. 83 ± 11 mg/dl, respectively). Plaque volume did not change from baseline to year 2 in either S+E (11.5 ± 1.4-10.5 ± 1.3 cm(3), p=NS) or S (11.0 ± 1.5-10.5 ± 1.4 cm(3), p=NS). In E, plaque progressed from baseline to year 2 (10.0 ± 0.8-10.8 ± 0.9, p<0.01) despite a 22% decrease in LDL-C. CONCLUSIONS: Statin initiation with or without ezetimibe in statin-naïve patients halts progression of peripheral atherosclerosis. When ezetimibe is added to patients previously on statins, peripheral atherosclerosis progressed. Thus, ezetimibe's effect on peripheral atherosclerosis may depend upon relative timing of statin therapy. |
| | |
Authors:
|
Amy M West; Justin D Anderson; Craig H Meyer; Frederick H Epstein; Hongkun Wang; Klaus D Hagspiel; Stuart S Berr; Nancy L Harthun; Joseph M DiMaria; Jennifer R Hunter; John M Christopher; Joshua D Chew; Gabriel B Winberry; Christopher M Kramer |
Related Documents
:
|
3598215 - Bacteriuria with a multiply resistant species of corynebacterium (corynebacterium group... 18082695 - The effectiveness of ureteric reimplantation during bladder augmentation for high-grade... 7742845 - External urethral sphincterotomy: long-term follow-up. 8709365 - The le bag orthotopic urinary diversion. 15383885 - The use of tissue adhesive for skin closure in body contouring surgery. 7861815 - Current concepts in anticoagulant therapy. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2011-04-16 |
Journal Detail:
|
Title: Atherosclerosis Volume: 218 ISSN: 1879-1484 ISO Abbreviation: Atherosclerosis Publication Date: 2011 Sep |
Date Detail:
|
Created Date: 2011-09-05 Completed Date: 2012-04-05 Revised Date: 2012-09-27 |
Medline Journal Info:
|
Nlm Unique ID: 0242543 Medline TA: Atherosclerosis Country: Ireland |
Other Details:
|
Languages: eng Pagination: 156-62 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
|
Department of Medicine, University of Virginia Health System, University of Virginia, Charlottesville, VA 22908, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00587678 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anticholesteremic Agents / therapeutic use Atherosclerosis / drug therapy* Azetidines / administration & dosage* Cholesterol, LDL / blood Double-Blind Method Female Femoral Artery / drug effects Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Magnetic Resonance Imaging / methods Male Middle Aged Peripheral Arterial Disease / drug therapy* Plaque, Atherosclerotic / drug therapy Prospective Studies Simvastatin / administration & dosage Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
M01RR000847/RR/NCRR NIH HHS; R01 HL075792/HL/NHLBI NIH HHS; R01 HL075792-05/HL/NHLBI NIH HHS; T32 EB003841/EB/NIBIB NIH HHS; T32 EB003841-05/EB/NIBIB NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Anticholesteremic Agents; 0/Azetidines; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 163222-33-1/ezetimibe; 79902-63-9/Simvastatin |
| Comments/Corrections | |
Comment In:
|
Atherosclerosis. 2011 Sep;218(1):23-5
[PMID:
21704315
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Adult patients' adherence to anti-retroviral treatment: A survey correlating pharmacy refill records...
Next Document: Association between glycosylated haemoglobin A(1c) and endothelial function in an adult non-diabetic...