| Author(s): |
Kasmas, S. H.
[1]
;
Izar, M. C.
[1, 2]
;
Franca, C. N.
[1]
;
Ramos, S. C.
[1]
;
Moreira, F. T.
[1]
;
Helfenstein, T.
[1, 2]
;
Moreno, R. A.
[3]
;
Borges, N. C.
[3]
;
Figueiredo-Neto, A. M.
[2]
;
Fonseca, F. A.
[1, 2]
Total Authors: 10
|
| Affiliation: | [1] Univ Fed Sao Paulo, Div Cardiol, Dept Med, BR-04039030 Sao Paulo - Brazil
[2] Inst Nacl Ciencia & Tecnol Fluidos Complexos, Sao Paulo - Brazil
[3] Synchrophar, Campinas, SP - Brazil
Total Affiliations: 3
|
Effective statin therapy is associated with a marked reduction of cardiovascular events. However, the explanation for full benefits obtained for LDL cholesterol targets by combined lipid-lowering therapy is controversial. Our study compared the effects of two equally effective lipid-lowering strategies on markers of cholesterol synthesis and absorption. A prospective, open label, randomized, parallel design study, with blinded endpoints, included 116 subjects. We compared the effects of a 12-week treatment with 40 mg rosuvastatin or the combination of 40 mg simvastatin/10 mg ezetimibe on markers of cholesterol absorption (campesterol and beta-sitosterol), synthesis (desmosterol), and their ratios to cholesterol. Both therapies similarly decreased total and LDL cholesterol, triglycerides and apolipoprotein B, and increased apolipoprotein A1 (P < 0.05 vs baseline for all). Simvastatin/ezetimibe increased plasma desmosterol (P = 0.012 vs baseline), and decreased campesterol and beta-sitosterol (P < 0.0001 vs baseline for both), with higher desmosterol (P = 0.007) and lower campesterol and beta-sitosterol compared to rosuvastatin, (P < 0.0001, for both). In addition, rosuvastatin increased the ratios of these markers to cholesterol (P < 0.002 vs baseline for all), whereas simvastatin/ezetimibe significantly decreased the campesterol/cholesterol ratio (P = 0.008 vs baseline) and tripled the desmosterol/cholesterol ratio (P < 0.0001 vs baseline). The campesterol/cholesterol and beta-sitosterol/cholesterol ratios were lower, whereas the desmosterol/cholesterol ratio was higher in patients receiving simvastatin/ezetimibe (P < 0.0001 vs rosuvastatin, for all). Pronounced differences in markers of cholesterol absorption and synthesis were observed between two equally effective lipid-lowering strategies. (AU) |