Korean Circ J.  2011 May;41(5):253-258. 10.4070/kcj.2011.41.5.253.

Effects of Ezetimibe Added to Ongoing Statin Therapy on C-Reactive Protein Levels in Hypercholesterolemic Patients

• Oh MS
• Min YJ
• Kwon JE
• Cho EJ
• Kim JE
• Lee WS
• Lee KJ
• Kim SW
• Kim TH
• Kim CJ
• Ryu WS

• KMID: 2297932
• DOI: http://doi.org/10.4070/kcj.2011.41.5.253

Abstract

BACKGROUND AND OBJECTIVES
Ezetimibe alone does not decrease C-reactive protein (CRP) levels in hypercholesterolemic patients. However, several reports have suggested that ezetimibe might potentiate the effect of statin not only on cholesterol but also on CRP when administered together. We investigated the effect of ezetimibe on CRP levels in patients taking statins.
SUBJECTS AND METHODS
Patients who had not achieved recommended low density lipoprotein-cholesterol (LDL-C) goals with statin therapy were divided into two groups, the ezetimibe group (n=60) and the control group (n=60). A third group of hypercholesterolemic patients without statin therapy was treated with statin (n=59). Patients with CRP level 10 mg/L were excluded. Lipid and CRP levels were measured before therapy commenced, and after 2 months of therapy.
RESULTS
Ezetimibe decreased cholesterol and LDL-C levels by 20.2% (p=0.000) and 28.1% (p=0.000) respectively. However, ezetimibe did not reduce CRP levels (from 0.83+/-0.68 to 1.14+/-1.21 mg/dL, p=0.11). CRP levels remained unchanged in the control group (p=0.42). In contrast, statin lowered CRP levels (from 0.82+/-0.73 to 0.65+/-0.57 mg/dL, p=0.008). In patients taking statins, changes in CRP levels were not associated with changes in LDL-C (r=-0.02, p=0.87), but with baseline CRP levels (r=-0.38, p=0.000).
CONCLUSION
Ezetimibe failed to reduce CRP levels in hypercholesterolemic patients taking statins despite significant reduction of LDL-C. This finding suggests that the anti-inflammatory effect of statin may not be secondary to cholesterol reduction, but via other mechanisms.

Keyword

C-reactive protein; Azetidines; HMG CoA reductase inhibitor; Lipid; Lipoproteins

MeSH Terms

Azetidines
C-Reactive Protein
Cholesterol
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoproteins
Ezetimibe
Azetidines
C-Reactive Protein
Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoproteins

Figure

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  Fig. 1 The relation between baseline CRP levels and changes in CRP levels in the control and the ezetimibe groups. CRP: C-reactive protein.

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