AI Article Synopsis
- * A study found that switching from standard statin doses to a combination therapy of ezetimibe and simvastatin was more effective in reducing LDL particle numbers and increasing HDL particle numbers compared to merely doubling the statin dose or switching to another statin.
- * The new combination therapy also significantly reduced a specific inflammatory marker (Lp-PLA2) more than just doubling the statin dose, suggesting it may be a better option for managing lipid levels in these patients.
Article Abstract
Background: Patients with diabetes mellitus and cardiovascular disease may not achieve adequate low-density lipoprotein cholesterol (LDL-C) lowering on statin monotherapy, attributed partly to atherogenic dyslipidemia. More intensive LDL-C-lowering therapy can be considered for these patients. A previous randomized, controlled study demonstrated greater LDL-C lowering in diabetic patients with symptomatic cardiovascular disease who switched from simvastatin 20 mg (S20) or atorvastatin 10 mg (A10) to combination ezetimibe/simvastatin 10/20 mg (ES10/20) therapy, compared with statin dose-doubling (to S40 or A20) or switching to rosuvastatin 10 mg (R10). The effect of these regimens on novel biomarkers of atherogenic dyslipidemia (low- and high-density lipoprotein particle number and lipoprotein-associated phospholipase A2 [Lp-PLA2]) was assessed.
Methods And Results: Treatment effects on low- and high-density lipoprotein particle number (by NMR) and Lp-PLA2 (by ELISA) were evaluated using plasma samples available from 358 subjects in the study. Switching to ES10/20 reduced low-density lipoprotein-particle number numerically more than did statin dose-doubling and was comparable with R10 (-133.3, -94.4, and -56.3 nmol/L, respectively; P>0.05). Increases in high-density lipoprotein particle number were significantly greater with switches to ES10/20 versus statin dose-doubling (1.5 and -0.5 μmol/L; P<0.05) and comparable with R10 (0.7 μmol/L; P>0.05). Percentages of patients attaining low-density lipoprotein particle number levels <990 nmol/L were 62.4% for ES10/20, 54.1% for statin dose-doubling, and 57.0% for R10. Switching to ES10/20 reduced Lp-PLA2 activity significantly more than did statin dose-doubling (-28.0 versus -3.8 nmol/min per mL, P<0.05) and was comparable with R10 (-28.0 versus -18.6 nmol/min per mL; P>0.05); effects on Lp-PLA2 concentration were modest.
Conclusions: In diabetic patients with dyslipidemia, switching from statins to combination ES10/20 therapy generally improved lipoprotein subclass profile and Lp-PLA2 activity more than did statin dose-doubling and was comparable with R10, consistent with its lipid effects.
Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00862251.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845107 | PMC |
| http://dx.doi.org/10.1161/JAHA.114.001675 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The peptidoglycan (PG) cell wall is the primary protective layer of bacteria, making the process of PG synthesis a key antibiotic target. Class A penicillin-binding proteins (aPBPs) are a family of conserved and ubiquitous PG synthases that fortify and repair the PG matrix. In gram-negative bacteria, these enzymes are regulated by outer-membrane tethered lipoproteins.
View Article and Find Full Text PDFAssessment of the diagnostic value of serum cathepsin S and its correlation with HDL subclasses in patients with non-Hodgkin's lymphoma.
J Med Biochem
September 2024
University of Belgrade, Faculty of Pharmacy, Department of Medical Biochemistry, Belgrade, Serbia.
Background: Recent findings point to the key role of cathepsin S (CTSS) in the survival of malignant cells, as well as the significance of the anti-apoptotic properties of high-density lipoprotein (HDL) that contribute to enhanced cell survival. The purpose of this study is to analyse CTSS as a potential biomarker in lymphoma. Also, in order to better understand the role of CTSS in the origin and development of lymphoma, its association with cystatin C (Cys C), lipids, and inflammatory markers was analysed.
View Article and Find Full Text PDFChoice of size-exclusion chromatography column affects recovery, purity, and miRNA cargo analysis of extracellular vesicles from human plasma.
Extracell Vesicles Circ Nucl Acids
September 2024
Department of Clinical Chemistry, Laboratory of Experimental Clinical Chemistry, Amsterdam Vesicle Center, Amsterdam UMC, location University of Amsterdam, Amsterdam 1105 AZ, the Netherlands.
Aim: The miRNA cargo of plasma extracellular vesicles (EVs) is commonly studied for its biomarker potential. However, isolation of EVs from human plasma is challenging. Although size-exclusion chromatography (SEC) is commonly used to isolate plasma EVs, SEC does not completely separate EVs from other miRNA carriers such as cells, lipoproteins, and proteins.
View Article and Find Full Text PDFEffects of Pemafibrate on LDL-C and Related Lipid Markers in Patients with MASLD: A Sub-Analysis of the PEMA-FL Study.
J Atheroscler Thromb
December 2024
Department of Cardiology, Rinku General Medical Center.
Aim: In the PEMA-FL study in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), pemafibrate was shown to significantly decrease low-density lipoprotein cholesterol (LDL-C) levels. We aimed to investigate the mechanisms of pemafibrate-induced LDL-C reduction in patients with MASLD by conducting an additional sub-analysis of the PEMA-FL study.
Methods: The PEMA-FL study randomized 118 patients with MASLD to receive pemafibrate or placebo for 72 weeks.
Hypertension and High-Density Lipoprotein Cholesterol: A Narrative Review.
Curr Hypertens Rev
December 2024
Hypertension Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Hypertension remains the primary driver of Cardiovascular Diseases (CVDs) and mortality. Dyslipidaemia is a common risk factor for CVDs in hypertensive patients, and their coexistence significantly increases the risk of CVDs. Furthermore, epidemiologic studies indicate that there are U-shaped curves between cholesterol levels of HDL-C and CVDs-related mortality in patients with hypertension, in which CVDs are paradoxically increased in those with elevated HDLC levels.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!