Effects Of Ezetimibe Combined With Statin On Inflammatory Markers、Clinical Outcome In Patients With Acute Coronary Syndrome

Objective:To investigate the effects and safety of different dosage of ezetimibe combined with simvastatin on high sensitivity-C-reactive protein(hs-CRP) and other inflammatory markers in patients with acute coronary syndrome (ACS), and the effects of the short-term combination treatments on long-term clinical outcome.Methods:81patients (55males,26females, aged65±10.1yrs) with ACS were randomly divided into three groups:simvastatin along group (n=27), normal dosage combination group (n=27), low dosage combination group(ezetimibe combined with simvastatin group, n=27), and each patient receiving1week treatment. hs-CRP、white blood cell count (WBC)、percentage of neutrophils (N)、uric acid (UA) and blood lipids were measured before and after intervention, adverse drug effects were recorded. All the patients received coronary heart disease secondary prevention treatments after discharging from hospital.After6months follow up, compared ischaemic events among these three groups.Results:(1) After7days treatment, low density lipoprotein-cholesterol (LDL-C) and total cholesterol (TC) levels in the3groups were significantly lower than baselines (P<0.01). Triglyeride (TG) and high density lipoprotein-cholesterol (HDL-C) levels in the3groups were no significant lower (P>0.05)(2) After7days treatment, hs-CRP level in the three groups were lower than baseline (P<0.05), and hs-CRP level in the low dosage and normal dosage combination groups were significantly lower than baseline (P<0.01).WBC and N levels in the3groups were lower than baselines (P<0.05)(3) After7days treatment, UA level in the low dosage and normal dosage combination groups were lower than baseline (P<0.05)(4) There was no case withdrew because of adverse drug effects in the3groups.(5)After6months follow up, there was no significant difference observed among these3groups (P>0.05)Conclusion:(1) low dosage combination of ezetimibe and simvastatin can inhibit inflammatory responses, significantly reduce hs-CRP level, decrease white blood cell count、percentage of neutrophils、low density lipoprotein-cholesterol and total cholesterol in ACS patients, its effect is as same as normal dosage combination, and low dosage combination is safe.(2) Combination of ezetimibe and simvastatin can significantly reduce uric acid level in ACS patients, but their specific mechanism is still unknown.(3) Compared with simvastatin monotherapy, combination of ezetimibe and simvastatin can not improve the long-term clinical outcome after the short-term treatment.