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 .
Adiponectin plasma levels are increased by atorvastatin treatment in subjects at high cardiovascular risk.
Adiponectin can suppress atherogenesis by inhibiting the adherence of monocytes , reducing their phagocytic activity , and suppressing the accumulation of modified lipoproteins in the vascular wall . Contradictory data have been reported about the effect of statins on adiponectin plasma levels . In this work , adiponectin plasma levels were measured in 102 statin-free subjects from the Spanish population of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration ( ACTFAST ) study , a 12-week , prospect i ve , multi-centre , open-label trial which enrolled subjects with coronary heart disease , coronary heart disease-equivalent or a 10-year coronary heart disease risk > 20 % . Subjects were assigned to atorvastatin ( 10 - 80 mg/day ) based on low-density lipoprotein (LDL)-cholesterol concentration at screening . For comparison , age and gender-matched blood donors ( N=40 ) were used as controls . Control subjects did not present hypertension , hypercholesterolemia , diabetes , metabolic syndrome and history of cardiovascular diseases . Adiponectin levels were diminished in patients at high cardiovascular risk compared with control subjects [ 4166 ( 3661 - 4740 ) vs 5806 ( 4764 - 7075 ) ng/ml respectively ; geometric mean ( 95 % CI ) ; P<0.0001 ] . In the whole population , atorvastatin treatment increased adiponectin levels [ 9.7 (3.2 - 16.7);% Change ( 95 % CI ) ; P=0.003 ] . This increment was in a dose-dependent manner ; maximal effect observed with atorvastatin 80 mg/d [ 24.7 ( 5.7 - 47.1 ) ; P=0.01 ] . Adiponectin concentrations were positively correlated with high-density lipoprotein-cholesterol both before and after atorvastatin treatment . No association was observed between adiponectin and LDL-cholesterol before and after atorvastatin treatment . In conclusion , atorvastatin increased adiponectin plasma levels in subjects at high cardiovascular risk , revealing a novel anti-inflammatory effect of this drug
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 .