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Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study).
J Clin Lipidol. 2011 Nov-Dec; 5(6):474-82.JC

Abstract

BACKGROUND

Metabolic syndrome (MetS) and atherosclerotic vascular disease (AVD) are associated with increased coronary heart disease risk.

OBJECTIVE

To assess percent change from baseline in lipids and high-sensitivity C-reactive protein (hs-CRP) levels and the proportion of subjects reaching specified low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C) and apolipoprotein B (Apo B) single, dual, and triple targets and hs-CRP <2 mg/L among subjects with and without AVD treated with ezetimibe/simvastatin or atorvastatin for 6 weeks.

METHODS

Adults (N = 1143) with MetS and hypercholesterolemia were randomized to starting and next higher doses of ezetimibe/simvastatin (10/20 or 10/40 mg) or atorvastatin (10, 20, or 40 mg).

RESULTS

Ezetimibe/simvastatin produced significantly greater reductions in evaluated lipids than atorvastatin for most prespecified dose comparisons. More subjects without AVD achieved LDL-C levels <100 mg/dL, non-HDL-C levels <130 mg/dL, and dual LDL-C/non-HDL targets (83%-92% vs 62%-76%) and Apo B <90 mg/dL or triple targets (65%-75% vs 41%-49%) with 40 mg of atorvastatin or 10/20-40 mg of ezetimibe/simvastatin compared with 10 or 20 mg of atorvastatin, respectively. More subjects with AVD achieved LDL-C<70 mg/dL and non-HDL-C<100 mg/dL single and dual targets (65%-80%) and Apo B <80 mg/dL (53%-63%) with 10/20-40 mg of ezetimibe/simvastatin than with 40 mg of atorvastatin (40%-49%). More subjects achieved triple lipid targets with 10/20-40 mg of ezetimibe/simvastatin versus 10-40 mg of atorvastatin (50%-63% vs 24%-40%). Achievement of hs-CRP <2 mg/L was similar across all doses regardless of AVD status.

CONCLUSIONS

More intensive therapy was required for >80% of subjects to achieve LDL-C <100 mg/dL and non-HDL-C <130 mg/dL and for the majority of subjects to achieve lower levels of LDL-C <70 mg/dL, non-HDL-C <100 mg/dL, and/or Apo B <90 mg/dL. The effect of ezetimibe on cardiovascular risk reduction has yet to be established. (Clintrials.gov no: NCT00409773).

Authors+Show Affiliations

Departments of Epidemiology & Medicine, University of Iowa College of Public Health, Iowa City, IA 52242, USA. jennifer-g-robinson@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22108151

Citation

Robinson, Jennifer G., et al. "Achievement of Specified Low-density Lipoprotein Cholesterol, Non-high-density Lipoprotein Cholesterol Apolipoprotein B, and High-sensitivity C-reactive Protein Levels With Ezetimibe/simvastatin or Atorvastatin in Metabolic Syndrome Patients With and Without Atherosclerotic Vascular Disease (from the VYMET Study)." Journal of Clinical Lipidology, vol. 5, no. 6, 2011, pp. 474-82.
Robinson JG, Ballantyne CM, Hsueh W, et al. Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study). J Clin Lipidol. 2011;5(6):474-82.
Robinson, J. G., Ballantyne, C. M., Hsueh, W., Rosen, J., Lin, J., Shah, A., Lowe, R. S., Hanson, M. E., & Tershakovec, A. M. (2011). Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study). Journal of Clinical Lipidology, 5(6), 474-82. https://doi.org/10.1016/j.jacl.2011.06.004
Robinson JG, et al. Achievement of Specified Low-density Lipoprotein Cholesterol, Non-high-density Lipoprotein Cholesterol Apolipoprotein B, and High-sensitivity C-reactive Protein Levels With Ezetimibe/simvastatin or Atorvastatin in Metabolic Syndrome Patients With and Without Atherosclerotic Vascular Disease (from the VYMET Study). J Clin Lipidol. 2011 Nov-Dec;5(6):474-82. PubMed PMID: 22108151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study). AU - Robinson,Jennifer G, AU - Ballantyne,Christie M, AU - Hsueh,Willa, AU - Rosen,Jeffrey, AU - Lin,Jianxin, AU - Shah,Arvind, AU - Lowe,Robert S, AU - Hanson,Mary E, AU - Tershakovec,Andrew M, Y1 - 2011/06/15/ PY - 2010/12/10/received PY - 2011/04/20/revised PY - 2011/06/06/accepted PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/3/13/medline SP - 474 EP - 82 JF - Journal of clinical lipidology JO - J Clin Lipidol VL - 5 IS - 6 N2 - BACKGROUND: Metabolic syndrome (MetS) and atherosclerotic vascular disease (AVD) are associated with increased coronary heart disease risk. OBJECTIVE: To assess percent change from baseline in lipids and high-sensitivity C-reactive protein (hs-CRP) levels and the proportion of subjects reaching specified low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C) and apolipoprotein B (Apo B) single, dual, and triple targets and hs-CRP <2 mg/L among subjects with and without AVD treated with ezetimibe/simvastatin or atorvastatin for 6 weeks. METHODS: Adults (N = 1143) with MetS and hypercholesterolemia were randomized to starting and next higher doses of ezetimibe/simvastatin (10/20 or 10/40 mg) or atorvastatin (10, 20, or 40 mg). RESULTS: Ezetimibe/simvastatin produced significantly greater reductions in evaluated lipids than atorvastatin for most prespecified dose comparisons. More subjects without AVD achieved LDL-C levels <100 mg/dL, non-HDL-C levels <130 mg/dL, and dual LDL-C/non-HDL targets (83%-92% vs 62%-76%) and Apo B <90 mg/dL or triple targets (65%-75% vs 41%-49%) with 40 mg of atorvastatin or 10/20-40 mg of ezetimibe/simvastatin compared with 10 or 20 mg of atorvastatin, respectively. More subjects with AVD achieved LDL-C<70 mg/dL and non-HDL-C<100 mg/dL single and dual targets (65%-80%) and Apo B <80 mg/dL (53%-63%) with 10/20-40 mg of ezetimibe/simvastatin than with 40 mg of atorvastatin (40%-49%). More subjects achieved triple lipid targets with 10/20-40 mg of ezetimibe/simvastatin versus 10-40 mg of atorvastatin (50%-63% vs 24%-40%). Achievement of hs-CRP <2 mg/L was similar across all doses regardless of AVD status. CONCLUSIONS: More intensive therapy was required for >80% of subjects to achieve LDL-C <100 mg/dL and non-HDL-C <130 mg/dL and for the majority of subjects to achieve lower levels of LDL-C <70 mg/dL, non-HDL-C <100 mg/dL, and/or Apo B <90 mg/dL. The effect of ezetimibe on cardiovascular risk reduction has yet to be established. (Clintrials.gov no: NCT00409773). SN - 1933-2874 UR - https://www.unboundmedicine.com/medline/citation/22108151/Achievement_of_specified_low_density_lipoprotein_cholesterol_non_high_density_lipoprotein_cholesterol_apolipoprotein_B_and_high_sensitivity_C_reactive_protein_levels_with_ezetimibe/simvastatin_or_atorvastatin_in_metabolic_syndrome_patients_with_and_without_atherosclerotic_vascular_disease__from_the_VYMET_study__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1933-2874(11)00611-8 DB - PRIME DP - Unbound Medicine ER -