CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect  compared with statin monotherapy .
AIMS Statins are known to influence the status of adipokines , which play a key role in the pathophysiology of cardiometabolic diseases .
As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear , the aim of the present study was to investigate this through a meta- analysis of controlled trials .
Ezetimibe Combined With Simvastatin Compared With Simvastatin Alone Results in a Greater Suppression of Oxidative Stress and Enhanced Fibrinolysis in Patients After Acute Coronary Events
We compared the effect of simvastatin versus simvastatin combined with ezetimibe on hemostasis and inflammation after acute coronary events [ acute coronary syndromes ( ACS ) ] . In an investigator-initiated , double-blind , placebo-controlled , r and omized study , patients with ACS were assigned to 40 mg/d of simvastatin + 10 mg/d of ezetimibe ( n = 26 ) or 40 mg/d of simvastatin + placebo ( n = 28 ) administered for 2 months . Markers of coagulation ( prothrombin fragments 1.2 , thrombin-antithrombin complexes , free tissue factor pathway inhibitor ) , fibrinolysis [ plasminogen activator inhibitor-1 , clot lysis time ( CLT ) ] , platelet activation ( soluble CD40 lig and , β-thromboglobulin , thromboxane B2 ) , oxidative stress [ 8-iso-prostagl and in F2α ( 8-iso-PGF2α ) ] , and inflammation ( interleukin-6 , interleukin-18 , and interleukin-1β ) were measured within the first 12 hours of ACS and at 1 and 2 months of therapy . A final analysis comprised 20 patients in the simvastatin + ezetimibe group and 26 patients in the simvastatin + placebo group . Both groups were similar with regard to demographics , risk factors , medications , and routine laboratory results . Inflammatory , coagulation , and platelet markers did not differ between both treatment groups at all time points . Reductions in low-density lipoprotein cholesterol , CLT , plasminogen activator inhibitor-1 , and 8-iso-PGF2α were significantly greater ( by 10 % , 8.7 % , 17.5 % , and 22.4 % ) in the simvastatin + ezetimibe group after 1 month , with further decreases in CLT and 8-iso-PGF2α at 2 months ( all P < 0.05 ) . These changes were not associated with lipid and inflammatory parameters . In conclusion , compared with simvastatin alone , simvastatin + ezetimibe results in a greater suppression of oxidative stress and enhanced fibrinolysis in patients with ACS , indicating that ezetimibe might exert cholesterol-independent actions in humans ( NCT00725829 )
CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect  compared with statin monotherapy .
AIMS Statins are known to influence the status of adipokines , which play a key role in the pathophysiology of cardiometabolic diseases .
As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear , the aim of the present study was to investigate this through a meta- analysis of controlled trials .