Ezetimibe Improves Rosuvastatin Effects on Inflammation and Vascular Endothelial Function in Acute Coronary Syndrome Patients Undergoing PCI

Abstract

Background. Little is known of the acute effects of ezetimibe in patients with acute coronary syndrome (ACS) undergoing PCI. We investigated whether ezetimibe improves inflammation and vascular endothelial function in patients with ACS undergoing PCI. Methods. We randomized 171 patients with ACS undergoing PCI to receive ezetimibe 10 mg/day plus rosuvastatin 20 mg/day (combination group, n = 81) versus rosuvastatin 20 mg/day (rosuvastatin group, n = 90). Lipid profile, type II secretory phospholipase A2 (sPLA2-IIa), interleukin-1β (IL-1β), vascular cell adhesion molecule-1 (VCAM-1), and intercellular cell adhesion molecule-1 (ICAM-1) were measured at baseline and after 7 days. Three months after PCI, clinical outcomes were examined. Result. The levels of sPLA2-IIa and IL-1β reduced significantly in both groups, but more when ezetimibe and rosuvastatin were coadministered (sPLA2-IIa: 6.16 ± 2.67 vs. 7.42 ± 3.53 ng/ml, p = 0.01 ; IL-1β: 37.39 ± 26.25 vs. 48.98 ± 32.26 pg/ml, p = 0.01 ). A significant rise of VCAM-1 and ICAM-1 was observed on day 7 after PCI in the both groups, but was less in the combination group (VCAM-1: 918.28 ± 235.31 vs. 988.54 ± 194.41 ng/ml, p = 0.03 ; ICAM-1: 213.01 ± 100.15 vs. 246.88 ± 105.71 ng/ml, p = 0.03 ). Patients in the combination versus rosuvastatin group appeared to suffer from less major adverse events. Periprocedural therapy of ezetimibe improves rosuvastatin effects on proinflammatory responses and endothelial function associated with ACS patients undergoing PCI. This trial is registered with https://clinicaltrials.gov/ct2/show/ChiCTR-IPR-17012219 (Chinese Clinical Trial Registry, http://www.chictr.org.cn on 02/08/2017).

Implications of Ezetimibe in Combination with Low- to Moderate-Intensity Atorvastatin Adjuvant Aspirin Therapy for Cerebrovascular Disease

“…This result indicates that ezetimibe combined with low- to medium-strength atorvastatin supplemented with aspirin can greatly improve the cognitive function and quality of life of the patients. The results of a study by Sun et al [ 9 ] showed that ezetimibe combined with rosuvastatin was clinically effective in treating early-onset coronary artery disease, effectively reducing serum MCP-1 and MIP-1 α expression, regulating blood lipids, and improving cardiac function without increasing adverse effects. In this paper, TG, TC, and LDL-C levels were lower, and HDL-C levels were higher in the study group after treatment.…”

Effectiveness of lipid-lowering therapy on mortality and major adverse cardiovascular event outcomes in patients undergoing percutaneous coronary intervention: a network meta-analysis of randomised controlled trials

“…The following articles were excluded: dose–response studies (8); those where no PCI population or subgroup was reported (6); those where no mortality or MACE-related outcomes were reported (6); repeated publications (5); studies related to preloading of lipid-lowering agents (4); studies unrelated to lipid-lowering agents (3); a protocol study (1) and a study with a non-randomised controlled trial (RCT) design (1). Finally, 39 articles were included, containing 54 478 post-PCI patients15–53 (figure 1).…”

Comparative Efficacy of Rosuvastatin Monotherapy and Rosuvastatin/Ezetimibe Combination Therapy on Insulin Sensitivity and Vascular Inflammatory Response in Patients with Type 2 Diabetes Mellitus

“…Although there are only a few studies on the effect of ezetimibe on ICAM-1, the available results are also controversial. One study reported that ICAM-1 increased following rosuvastatin monotherapy and rosuvastatin/ezetimibe combination therapy but was less in the combination therapy [ 41 ]. However, another study reported that ICAM-1 decreased following simvastatin monotherapy and simvastatin/ezetimibe combination therapy but was higher in the combination therapy [ 42 ].…”