Similar trends were observed for changes in total cholesterol .
Implication sGiven the available data , the addition of ezetimibe to ongoing simvastatin , atorvastatin , or rosuvastatin monotherapy offers greater reduction in LDL-C among patients at high risk of CVD compared to doubling the initial statin dose
Purpose While statins are used as first-line treatments for high-risk patients with hypercholesterolemia , statin monotherapy is often insufficient to achieve target low-density lipoprotein cholesterol ( LDL-C ) levels .
Second-line treatment options include up-titration of statin dose , switching to a more potent statin , or combination therapy , e.g. , with ezetimibe .
The aim of this study was to evaluate the efficacy of adding ezetimibe to simvastatin , atorvastatin , or rosuvastatin monotherapy versus doubling the dosage or switching to a higher-potency statin in a population of patients with hypocholesterolemia at high risk of cardiovascular disease ( CVD ) and who had been previously treated with a statin .
The Effect of Aggressive Versus Conventional Lipid-lowering Therapy on Markers of Inflammatory and Oxidative Stress
Purpose Recent trial results are in favor of aggressive lipid lowering using high dose statins in patients needing secondary prevention . It is unclear whether these effects are solely due to more extensive lipid lowering or the result of the potentially anti-inflammatory properties of statins . We aim ed to determine whether aggressive compared with conventional statin therapy is more effective in reducing systemic markers of inflammation and oxidative stress . Material s and methods This was a multi-centre , double-blind , placebo-controlled trial . Patients with previous cardiovascular disease , who did not achieve low density lipoprotein ( LDL ) cholesterol levels < 2.6 mmol/l on conventional statin therapy ( simvastatin 40 mg ) were r and omized to continue with simvastatin 40 mg or to receive atorvastatin 40 mg for 8 weeks and thereafter atorvastatin 80 mg for the final 8 weeks ( aggressive treatment ) . Lipids , C-reactive protein , soluble cellular adhesion molecules , neopterin , von Willebr and Factor , and antibodies against oxidized LDL were measured at baseline and after 16 weeks . Results Lipid levels decreased significantly in the aggressive treatment group ( LDL-C reduction 20.8 % ; P < 0.001 ) , whereas a slight increase was observed in the conventional group ( LDL-C increase 3.7 % ; P = 0.037 ) . A significant reduction in antibodies against oxidized LDL was seen in the aggressive ( 13.4 % ; P < 0.001 ) and the conventional ( 26.8 % ; P < 0.001 ) group , but there was no difference between groups ( P = 0.25 ) . Furthermore , no significant differences in change in other biomarkers was observed between both groups . Conclusions This study does not support the hypothesis that a more profound reduction in inflammatory and oxidative stress contributes to the benefits of aggressive statin therapy
Similar trends were observed for changes in total cholesterol .
Implication sGiven the available data , the addition of ezetimibe to ongoing simvastatin , atorvastatin , or rosuvastatin monotherapy offers greater reduction in LDL-C among patients at high risk of CVD compared to doubling the initial statin dose
Purpose While statins are used as first-line treatments for high-risk patients with hypercholesterolemia , statin monotherapy is often insufficient to achieve target low-density lipoprotein cholesterol ( LDL-C ) levels .
Second-line treatment options include up-titration of statin dose , switching to a more potent statin , or combination therapy , e.g. , with ezetimibe .
The aim of this study was to evaluate the efficacy of adding ezetimibe to simvastatin , atorvastatin , or rosuvastatin monotherapy versus doubling the dosage or switching to a higher-potency statin in a population of patients with hypocholesterolemia at high risk of cardiovascular disease ( CVD ) and who had been previously treated with a statin .