Conclusions Ezetimibe monotherapy ( 10 mg/day ) showed a small ( 7.06 % ) but statistically significant reduction in the plasma levels of Lp(a ) in patients with primary hypercholesterolemia .
According to current literature , this magnitude of reduction seems to have no clinical relevance .
Background and Aims Ezetimibe reduces plasma low-density lipoprotein cholesterol ( LDL-C ) levels by up to 20 % .
However , its effect on plasma lipoprotein(a ) [ Lp(a ) ] concentrations in patients with primary hypercholesterolemia has not been defined .
Objective Therefore , we performed a systematic review and meta- analysis to assess this effect based on the available r and omized controlled trials ( RCTs ) .
Effect of therapeutic interventions on oxidized phospholipids on apolipoprotein B100 and lipoprotein(a).
BACKGROUND Oxidized phospholipids ( OxPL ) on apolipoprotein B-100 ( OxPL-apoB ) reflect the biological activity of lipoprotein(a ) ( Lp[a ] ) and predict cardiovascular disease events . However , studies with statins and low-fat diets show increases in OxPL-apoB and Lp(a ) . OBJECTIVE This study evaluated changes in OxPL-apoB and Lp(a ) with extended-release niacin ( N ) , ezetimibe/simvastatin ( E/S ) and combination E/S/N. A systematic literature review of previously published trials , measuring both OxPL-apoB and Lp(a ) after therapeutic interventions , was also performed . METHODS OxPL-apoB and Lp(a ) were measured in 591 patients at baseline and 24 weeks after therapy with N , E/S , or E/S/N in a previously completed r and omized trial of hypercholesterolemic patients . The literature review included 12 trials and 3896 patients evaluating statins , low-fat diets , antisense to apolipoprotein(a ) and lipid apheresis . RESULTS Niacin decreased OxPL-apoB levels ( median [ interquartile range ] ; 3.5 [ 2.2 - 9.2 ] nM to 3.1 [ 1.8 - 7.2 ] nM , P < .01 ) and Lp(a ) ( 10.9 [ 4.6 - 38.4 ] to 9.3 [ 3.1 - 32.9 ] mg/dL , P < .01 ) . In contrast , E/S and E/S/N significantly increased OxPL-apoB ( 3.5 [ 2.1 - 7.8 ] to 4.9 [ 3.0 - 11.1 ] nM , P < .01 ) and ( 3.3 [ 1.9 - 9.3 ] to 4.3 [ 2.6 - 11.2 ] nM , P < .01 ) , respectively and Lp(a ) ( 11.5 [ 6.1 - 36.4 ] to 14.9 [ 6.6 - 54.6 ] mg/dL , P < .01 ) and ( 11.3 [ 5.4 - 43.8 ] to 11.6 [ 5.9 - 52.8 ] mg/dL , P < .01 ) , respectively . The systematic review of statins and diet demonstrated 23.8 % and 21.3 % mean increases in OxPL-apoB and 10.6 % and 19.4 % increases in Lp(a ) , respectively . However 44.1 % and 52.0 % decreases in OxPL-apoB and Lp(a ) , respectively , were present with Lp(a)-lowering therapies . CONCLUSIONS This study demonstrates differential changes in OxPL-apoB and Lp(a ) with various lipid-lowering approaches . These changes in OxPL-apoB and Lp(a ) may provide insights into the results and interpretation of recent cardiovascular disease outcomes trials
Conclusions Ezetimibe monotherapy ( 10 mg/day ) showed a small ( 7.06 % ) but statistically significant reduction in the plasma levels of Lp(a ) in patients with primary hypercholesterolemia .
According to current literature , this magnitude of reduction seems to have no clinical relevance .
Background and Aims Ezetimibe reduces plasma low-density lipoprotein cholesterol ( LDL-C ) levels by up to 20 % .
However , its effect on plasma lipoprotein(a ) [ Lp(a ) ] concentrations in patients with primary hypercholesterolemia has not been defined .
Objective Therefore , we performed a systematic review and meta- analysis to assess this effect based on the available r and omized controlled trials ( RCTs ) .