Athyros Vasilios G, Tziomalos Konstantinos, Kakafika Anna I, Koumaras Haralambos, Karagiannis Asterios, Mikhailidis Dimitri P
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
Am J Cardiol. 2008 Feb 15;101(4):483-5. doi: 10.1016/j.amjcard.2007.09.096. Epub 2007 Dec 20.
This study was undertaken to investigate the effect of ezetimibe (10 mg/day) alone or in combination with atorvastatin (10 mg twice a week) on hypercholesterolemia in 56 high-risk patients intolerant to daily statin use. Ezetimibe monotherapy was well tolerated (2 withdrawals) and induced a mean reduction in low-density lipoprotein (LDL) cholesterol of 20% (p <0.05) at the third month. However, of the 54 patients still taking ezetimibe, only 5 (9%) were at their LDL cholesterol targets. Atorvastatin 10 mg twice a week was then added to ezetimibe and was well tolerated (3 withdrawals). This combination reduced LDL cholesterol (in a treatment-based analysis) by 37% compared with baseline (p <0.001), with 43 (84%) patients reaching their LDL cholesterol goals. When patients (n = 34, 25 men) with baseline serum creatinine values in the upper 2 tertiles were analyzed separately, there was a significant (p = 0.041) decrease in serum creatinine levels after 6 months of treatment. In conclusion, the combination of ezetimibe plus atorvastatin 10 mg twice a week might be a therapeutic option for high-risk patients intolerant to daily statin monotherapy.
本研究旨在调查依折麦布（10毫克/天）单独使用或与阿托伐他汀（10毫克，每周两次）联合使用对56例不耐受每日使用他汀类药物的高危患者高胆固醇血症的影响。依折麦布单药治疗耐受性良好（2例退出），在第三个月时低密度脂蛋白（LDL）胆固醇平均降低20%（p<0.05）。然而，在仍服用依折麦布的54例患者中，只有5例（9%）达到LDL胆固醇目标。随后将阿托伐他汀10毫克每周两次添加到依折麦布中，耐受性良好（3例退出）。与基线相比，这种联合治疗使LDL胆固醇（基于治疗的分析）降低了37%（p<0.001），43例（84%）患者达到LDL胆固醇目标。当对基线血清肌酐值处于上三分位数的患者（n=34，25例男性）进行单独分析时，治疗6个月后血清肌酐水平有显著下降（p=0.041）。总之，依折麦布加阿托伐他汀10毫克每周两次的联合治疗可能是不耐受每日他汀类单药治疗的高危患者的一种治疗选择。
