A randomized, controlled comparison of different intensive lipid-lowering therapies in Chinese patients with non-ST-elevation acute coronary syndrome (NSTE-ACS): Ezetimibe and rosuvastatin versus high-dose rosuvastatin

Int J Cardiol. 2017 May 15:235:49-55. doi: 10.1016/j.ijcard.2017.02.099. Epub 2017 Feb 23.

Abstract

Background: Statin combined with ezetimibe demonstrates significant benefit in lowering low density lipid cholesterol (LDL-C) and cardiovascular events abroad, but whether intermediate intensity statins combined with ezetimibe is superior to high-intensity statin monotherapy in Chinese people is unknown.

Methods: A total of 125 patients were randomly assigned to a intermediate intensity rosuvastatin group (rosuvastatin 10mg/d, n=42), high-dose rosuvastatin group (rosuvastatin 20mg/d, n=41) or combination therapy group (ezetimibe 10mg/d and rosuvastatin 10mg/d, n=42) with a 12-week follow-up. The primary end point was the proportion of patients who achieved the 2011 ESC/EAS LDL-C goal <70mg/dL (1.8mmol/L) at week 12. Secondary end points included changes from baseline in lipids, the occurrence of all cardiovascular events, high-sensitivity C-reactive protein and safety markers.

Results: The combination therapy group in the primary end point was significantly higher than rosuvastatin (20mg) and rosuvastatin (10mg) at week 12 (81.0% vs 68.3% vs 33.3%, P<0.001). And the similar change was observed in reducing LDL-C levels at week 12 (67.28% vs 52.80% vs 43.89%, P<0.001). The incidence of drug-related adverse events was much higher in the rosuvastatin 20mg group than the rosuvastatin 10mg group and the combination therapy group (17.0% vs 2.4% vs 4.8%, P<0.05).

Conclusions: The combination of rosuvastatin 10mg/ezetimibe 10mg was an effectively alternative therapy superior to rosuvastatin 20mg or 10mg with a greater effect on lowering LDL-C and a lower incidence of drug-related adverse events in Chinese patients.

Keywords: Ezetimibe; Intensive lipid-lowering therapy; Rosuvastatin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Coronary Syndrome* / blood
  • Acute Coronary Syndrome* / diagnosis
  • Acute Coronary Syndrome* / epidemiology
  • Acute Coronary Syndrome* / prevention & control
  • Aged
  • Anticholesteremic Agents / administration & dosage
  • Anticholesteremic Agents / adverse effects
  • C-Reactive Protein / analysis
  • China / epidemiology
  • Cholesterol, LDL / blood*
  • Dose-Response Relationship, Drug
  • Drug Monitoring / methods
  • Drug Therapy, Combination / methods
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Electrocardiography / methods
  • Ezetimibe* / administration & dosage
  • Ezetimibe* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Rosuvastatin Calcium* / administration & dosage
  • Rosuvastatin Calcium* / adverse effects

Substances

  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Rosuvastatin Calcium
  • C-Reactive Protein
  • Ezetimibe