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Nakano Y, Yamamoto M, Matoba T, Katsuki S, Nakashiro S, Takase S, Akiyama Y, Nagata T, Mukai Y, Inoue S, Oi K, Higo T, Takemoto M, Suematsu N, Eshima K, Miyata K, Usui M, Sadamatsu K, Kadokami T, Hironaga K, Ichi I, Todaka K, Kishimoto J, Tsutsui H. Association between Serum Oxysterols and Coronary Plaque Regression during Lipid-Lowering Therapy with Statin and Ezetimibe: Insights from the CuVIC Trial. J Atheroscler Thromb 2023; 30:907-918. [PMID: 36450458 PMCID: PMC10406650 DOI: 10.5551/jat.63507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/23/2022] [Indexed: 08/04/2023] Open
Abstract
AIM Several clinical trials using intravascular ultrasound (IVUS) evaluation have demonstrated that intensive lipid-lowering therapy by statin or a combination therapy with statin and ezetimibe results in significant regression of coronary plaque volume. However, it remains unclear whether adding ezetimibe to statin therapy affects coronary plaque composition and the molecular mechanisms of plaque regression. We conducted this prospective IVUS analysis in a subgroup from the CuVIC trial. METHODS The CuVIC trial was a prospective randomized, open, blinded-endpoint trial conducted among 11 cardiovascular centers, where 260 patients with coronary artery disease who received coronary stenting were randomly allocated into either the statin group (S) or the combined statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39 patients; S+E group, 40 patients) in this substudy, for whom serial IVUS images of nonculprit lesion were available at both baseline and after 6-8 months of follow-up. RESULTS After the treatment period, the S+E group had significantly lower level of low-density lipoprotein cholesterol (LDL-C; 80.9±3.7 vs. 67.7±3.8 mg/dL, p=0.0143). Campesterol, a marker of cholesterol absorption, and oxysterols (β-epoxycholesterol, 4β-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in the S+E group. IVUS analyses revealed greater plaque regression in the S+E group than in the S group (-6.14% vs. -1.18% for each group, p=0.042). It was noteworthy that the lowering of campesterol and 27-hydroxycholesterol, but not LDL-C, had a significant positive correlation with plaque regression. CONCLUSIONS Compared with statin monotherapy, ezetimibe in combination with statin achieved significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which resulted in greater coronary plaque regression.
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Affiliation(s)
- Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mitsutaka Yamamoto
- Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Soichi Nakashiro
- Department of Cardiovascular Medicine, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yusuke Akiyama
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Shujiro Inoue
- Department of Cardiovascular Medicine, Aso Iizuka Hospital, Fukuoka, Japan
| | - Keiji Oi
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - Masao Takemoto
- Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Nobuhiro Suematsu
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Kenichi Eshima
- Department of Cardiovascular Medicine, Saga-ken Medical Centre Koseikan, Saga, Japan
| | - Kenji Miyata
- Department of Cardiovascular Medicine, Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan
| | - Makoto Usui
- Department of Cardiovascular Medicine, Hamanomachi Hospital, Fukuoka, Japan
| | - Kenji Sadamatsu
- Department of Cardiovascular Medicine, Omuta City Hospital, Fukuoka, Japan
| | - Toshiaki Kadokami
- Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
| | - Kiyoshi Hironaga
- Department of Cardiovascular Medicine, Fukuoka City Hospital, Fukuoka, Japan
| | - Ikuyo Ichi
- Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan
| | - Koji Todaka
- Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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2
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Liu Y, Yang X, Xiao F, Jie F, Zhang Q, Liu Y, Xiao H, Lu B. Dietary cholesterol oxidation products: Perspectives linking food processing and storage with health implications. Compr Rev Food Sci Food Saf 2021; 21:738-779. [PMID: 34953101 DOI: 10.1111/1541-4337.12880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022]
Abstract
Dietary cholesterol oxidation products (COPs) are heterogeneous compounds formed during the processing and storage of cholesterol-rich foods, such as seafood, meat, eggs, and dairy products. With the increased intake of COPs-rich foods, the concern about health implications of dietary COPs is rising. Dietary COPs may exert deleterious effects on human health to induce several inflammatory diseases including atherosclerosis, neurodegenerative diseases, and inflammatory bowel diseases. Thus, knowledge regarding the effects of processing and storage conditions leading to formation of COPs is needed to reduce the levels of COPs in foods. Efficient methodologies to determine COPs in foods are also essential. More importantly, the biological roles of dietary COPs in human health and effects of phytochemicals on dietary COPs-induced diseases need to be established. This review summarizes the recent information on dietary COPs including their formation in foods during their processing and storage, analytical methods of determination of COPs, metabolic fate, implications for human health, and beneficial interventions by phytochemicals. The formation of COPs is largely dependent on the heating temperature, storage time, and food matrices. Alteration of food processing and storage conditions is one of the potent strategies to restrict hazardous dietary COPs from forming, including maintaining relatively low temperatures, shorter processing or storage time, and the appropriate addition of antioxidants. Once absorbed into the circulation, dietary COPs can contribute to the progression of several inflammatory diseases, where the absorbed dietary COPs may induce inflammation, apoptosis, and autophagy in cells in the target organs or tissues. Improved intake of phytochemicals may be an effective strategy to reduce the hazardous effects of dietary COPs.
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Affiliation(s)
- Yan Liu
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Xuan Yang
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Fan Xiao
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Fan Jie
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Qinjun Zhang
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Yuqi Liu
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
| | - Hang Xiao
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Department of Food Science, University of Massachusetts, Amherst, Massachusetts, USA
| | - Baiyi Lu
- College of Biosystems Engineering and Food Science, National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China.,Ningbo Research Institute, Zhejiang University, Ningbo, China
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Inhibition of Niemann-Pick C1-Like 1 by Ezetimibe Reduces Dietary 5β,6β-Epoxycholesterol Absorption in Rats. Cardiovasc Drugs Ther 2019; 33:35-44. [PMID: 30671747 DOI: 10.1007/s10557-019-06854-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Oxycholesterols (OCs) are produced from cholesterol by oxidation of the steroidal backbone and side-chain. OCs are present in blood and evidence suggests their involvement in disease development and progression. However, limited information is available regarding the absorption mechanisms and relative absorption rates of dietary OCs. Although ezetimibe is known to inhibit intestinal cholesterol absorption via Niemann-Pick C1-Like 1 (NPC1L1), whether it also inhibits dietary OC absorption is unclear. METHODS We investigated the effects of ezetimibe on OC absorption in rats fed an OC-rich diet containing 10 different OCs. We collected lymphatic fluid using permanent cannulation of the thoracic duct and quantified OC levels. RESULTS Ezetimibe treatment significantly reduced the apparent absorption of 5β,6β-epoxycholesterol (5,6β-epoxy) and its levels in the proximal intestinal mucosa in OC-fed rats. Using in silico analyses, the binding energy of NPC1L1 N-terminal domain (NPC1L1-NTD) and 5,6β-epoxy was found to be similar to that of NPC1L1-NTD and cholesterol, suggesting that polar uncharged amino acids located in the steroidal part of 5,6β-epoxy were involved. CONCLUSION Our results indicate that ezetimibe-mediated inhibition of dietary OC absorption varies depending on the specific OC, and only the absorption of 5,6β-epoxy is significantly reduced.
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Honda K, Matoba T, Antoku Y, Koga JI, Ichi I, Nakano K, Tsutsui H, Egashira K. Lipid-Lowering Therapy With Ezetimibe Decreases Spontaneous Atherothrombotic Occlusions in a Rabbit Model of Plaque Erosion: A Role of Serum Oxysterols. Arterioscler Thromb Vasc Biol 2018; 38:757-771. [PMID: 29449331 DOI: 10.1161/atvbaha.117.310244] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/02/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Plaque erosion is increasing its importance as one of the mechanisms of acute coronary syndromes in this statin era. However, the clinical efficacy of currently used lipid-lowering agents in the prevention of thrombotic complications associated with plaque erosion has not been clarified. Therefore, we examined the therapeutic effects of ezetimibe or rosuvastatin monotherapy on spontaneous atherothrombotic occlusion. APPROACH AND RESULTS Femoral arteries of Japanese white rabbits, fed a high-cholesterol diet, were injured by balloon catheter, and then angiotensin II was continuously administrated. In 94% of these arteries, spontaneous thrombotic occlusions were observed after 5 weeks (median) of balloon injury. Histochemical analyses indicated that the injured arteries had similar pathological features to human plaque erosions; (1) spontaneous thrombotic occlusion, (2) lack of endothelial cells, and (3) tissue factor expression in vascular smooth muscle cells. Ezetimibe (1.0 mg/kg per day), but not rosuvastatin (0.6 mg/kg per day), significantly decreased thrombotic occlusion of arteries accompanied with accelerated re-endothelialization and the decreases of serum oxysterols despite the comparable on-treatment serum cholesterol levels. The 7-ketocholesterol inhibited the migration of human umbilical vein endothelial cells. Both 7-ketocholesterol and 27-hydroxycholesterol increased tissue factor expression in cultured rat vascular smooth muscle cells. Tissue factor expression was also induced by serum from vehicle- or rosuvastatin-treated rabbits, but the induction was attenuated with serum from ezetimibe-treated rabbits. CONCLUSIONS We have established a novel rabbit model of spontaneous atherothromobotic occlusion without plaque rupture that is feasible to test the therapeutic effects of various pharmacotherapies. Ezetimibe may decrease atherothrombotic complications after superficial plaque erosion by reducing serum oxysterols.
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Affiliation(s)
- Katsuya Honda
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Tetsuya Matoba
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.).
| | - Yoshibumi Antoku
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Jun-Ichiro Koga
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Ikuyo Ichi
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Kaku Nakano
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Hiroyuki Tsutsui
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
| | - Kensuke Egashira
- From the Department of Cardiovascular Medicine, Graduate School of Medical Sciences (K.H., T.M., Y.A., H.T.) and Department of Cardiovascular Research, Development, and Translational Medicine (J.K., K.N., K.E.), Kyushu University, Fukuoka, Japan; and Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (I.I.)
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5
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Takase S, Matoba T, Nakashiro S, Mukai Y, Inoue S, Oi K, Higo T, Katsuki S, Takemoto M, Suematsu N, Eshima K, Miyata K, Yamamoto M, Usui M, Sadamatsu K, Satoh S, Kadokami T, Hironaga K, Ichi I, Todaka K, Kishimoto J, Egashira K, Sunagawa K. Ezetimibe in Combination With Statins Ameliorates Endothelial Dysfunction in Coronary Arteries After Stenting. Arterioscler Thromb Vasc Biol 2017; 37:350-358. [DOI: 10.1161/atvbaha.116.308388] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022]
Abstract
Objectives—
We sought to investigate whether treatment with ezetimibe in combination with statins improves coronary endothelial function in target vessels in coronary artery disease patients after coronary stenting.
Approach and Results—
We conducted a multicenter, prospective, randomized, open-label, blinded-end point trial among 11 cardiovascular treatment centers. From 2011 to 2013, 260 coronary artery disease patients who underwent coronary stenting were randomly allocated to 2 arms (statin monotherapy, S versus ezetimibe [10 mg/d]+statin combinational therapy, E+S). We defined target vessel dysfunction as the primary composite outcome, which comprised target vessel failure during treatment and at the 6- to 8-month follow-up coronary angiography and coronary endothelial dysfunction determined via intracoronary acetylcholine testing performed in cases without target vessel failure at the follow-up coronary angiography. Coadministration of ezetimibe with statins further lowered low-density lipoprotein cholesterol levels (83±23 mg/dL in S versus 67±23 mg/dL in E+S;
P
<0.0001), with significant decreases in oxidized low-density lipoprotein and oxysterol levels. Among patients without target vessel failure, 46 out of 89 patients (52%) in the S arm and 34 out of 96 patients (35%) in the E+S arm were found to have coronary endothelial dysfunction (
P
=0.0256), and the incidence of target vessel dysfunction at follow-up was significantly decreased in the E+S arm (69/112 (62%) in S versus 47/109 (43%) in E+S;
P
=0.0059). A post hoc analysis of post-treatment low-density lipoprotein cholesterol–matched subgroups revealed that the incidence of both target vessel dysfunction and coronary endothelial dysfunction significantly decreased in the E+S arm, with significant reductions in oxysterol levels.
Conclusions—
The CuVIC trial (Effect of Cholesterol Absorption Inhibitor Usage on Target Vessel Dysfunction after Coronary Stenting) has shown that ezetimibe with statins, compared with statin monotherapy, improves functional prognoses, ameliorating endothelial dysfunction in stented coronary arteries, and was associated with larger decreases in oxysterol levels.
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Affiliation(s)
- Susumu Takase
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Tetsuya Matoba
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Soichi Nakashiro
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Yasushi Mukai
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shujiro Inoue
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Keiji Oi
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Taiki Higo
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shunsuke Katsuki
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Masao Takemoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Nobuhiro Suematsu
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenichi Eshima
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Miyata
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Mitsutaka Yamamoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Makoto Usui
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Sadamatsu
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Shinji Satoh
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Toshiaki Kadokami
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kiyoshi Hironaga
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Ikuyo Ichi
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Koji Todaka
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Junji Kishimoto
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kensuke Egashira
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
| | - Kenji Sunagawa
- From the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N., T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I., K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital, Japan (N.S.); St. Mary’s Hospital, Kurume, Japan (K. Eshima); Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (K.M.)
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Mori K, Ishida T, Tsuda S, Oshita T, Shinohara M, Hara T, Irino Y, Toh R, Hirata KI. Enhanced Impact of Cholesterol Absorption Marker on New Atherosclerotic Lesion Progression After Coronary Intervention During Statin Therapy. J Atheroscler Thromb 2016; 24:123-132. [PMID: 27487947 PMCID: PMC5305673 DOI: 10.5551/jat.32615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: Clinical trials suggest that residual risks remain for coronary artery disease (CAD) during low-density lipoprotein cholesterol (LDL-C) lowering therapy. We aimed to investigate the role of exogenous lipids in the prognosis of CAD after percutaneous coronary intervention (PCI). Methods: A total of 145 patients with CAD, who underwent elective PCI, and 82 non-CAD (control) patients were enrolled in this study. CAD patients underwent follow-up coronary angiography 6–9 months after PCI, and were classified into three groups: 1) patients who showed in-stent restenosis (ISR) in the original stented segment, 2) patients with other non-target coronary atherosclerotic lesions (de novo), and 3) patients with neither ISR nor a de novo lesion. Biochemical analyses were performed on fasting serum samples at the time of follow-up coronary angiography. Results: Despite the controlled serum LDL-C levels, CAD patients with statin showed elevated cholesterol absorption marker campesterol/total cholesterol (TC), synthesis marker lathosterol/TC, campesterol/lathosterol ratio, and apolipoprotein B48 (apoB48) concentration compared with non-CAD patients. The high campesterol/TC, campesterol/lathosterol ratio, and apoB48 concentration were associated with de novo lesion progression after PCI. In stepwise multivariate logistic regression analysis, campesterol/TC and apoB48 concentrations were independent risk factors for de novo lesion progression in statin-treated CAD patients after PCI. Conclusion: The increase of cholesterol absorption marker and apoB48 concentration may lead to the progression of de novo lesions, and these markers may represent a residual risk during statin treatment after PCI.
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Affiliation(s)
- Kenta Mori
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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7
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Ebisawa S, Izawa A, Ueki Y, Hioki H, Minamisawa M, Hashizume N, Abe N, Kashima Y, Miura T, Takeuchi T, Motoki H, Okada A, Miyashita Y, Koyama J, Ikeda U. Impact of combination therapy with statin and ezetimibe on secondary prevention for post-acute myocardial infarction patients in the statin era. IJC HEART & VASCULATURE 2015; 8:154-160. [PMID: 28785695 PMCID: PMC5497285 DOI: 10.1016/j.ijcha.2015.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/20/2015] [Accepted: 07/25/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known concerning the effect of ezetimibe for secondary prevention in post-myocardial infarction (MI) patients. In this study, we investigated the secondary prevention effect of ezetimibe for post-MI patients. METHODS This study is a retrospective analysis of Assessing Lipophilic vs. hydrophilic Statin therapy for Acute MI (ALPS-AMI study). The patients were divided into two groups: those administered a statin to control low density lipoprotein-cholesterol (LDL-C), the ezetimibe(-) group, and those administered ezetimibe in addition to a statin to control LDL-C, the ezetimibe(+) group. The endpoints were Major Adverse Cardiac and Cerebrovascular Event (MACCE), including all-cause death, recurrence of MI, stroke, and heart failure requiring hospitalization, and MACCE with revascularization. RESULTS The ezetimibe(+) and ezetimibe(-) groups contained 113 and 337 patients, respectively. Incidences of MACCE and MACCE with revascularization were lower in the ezetimibe(+) group than in the ezetimibe(-) group (2.6% vs. 11.5%, p = 0.002; 23.0% vs. 36.7%, p = 0.014, respectively). Moreover, logistic regression analysis revealed ezetimibe(+) was a significant negative predictor of MACCE (OR 0.208, 95% CI 0.048 to 0.903, p = 0.047) and MACCE with revascularization (OR 0.463, 95% CI 0.258 to 0.831, p = 0.008). The preventive effect of ezetimibe against MACCE was observed in both moderate- and high-intensity lipid lowering treatment groups (0% vs. 17%; p = 0.077, 3.1% vs. 9.4%; p = 0.033). CONCLUSIONS In lipid-lowering therapy post-MI, ezetimibe and statin combination therapy improved MACCE with or without revascularization compared with statin monotherapy. These findings suggest that post-MI secondary prevention should be more intensive.
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Affiliation(s)
- Soichiro Ebisawa
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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8
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Torimoto K, Okada Y, Mori H, Hajime M, Tanaka K, Kurozumi A, Narisawa M, Yamamoto S, Arao T, Matsuoka H, Inokuchi N, Tanaka Y. Efficacy of combination of Ezetimibe 10 mg and rosuvastatin 2.5 mg versus rosuvastatin 5 mg monotherapy for hypercholesterolemia in patients with type 2 diabetes. Lipids Health Dis 2013; 12:137. [PMID: 24053480 PMCID: PMC3849617 DOI: 10.1186/1476-511x-12-137] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/18/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Statins are used to treat hypercholesterolemia in patients with type 2 diabetes mellitus, but many of these patients fail to achieve the target LDL-C level. Recent reports have suggested that a synergistic effect can be obtained by concomitant administration of the cholesterol absorption inhibitor ezetimibe and a statin. However, in patients with type 2 diabetes who are already being treated with satins, it remains unclear whether it is more effective to add ezetimibe or to increase the statin dose. Therefore, this study was performed to examine the effects of these two regimens on LDL-C and lipoproteins. METHODS The subjects were type 2 diabetic patients under treatment with rosuvastatin (2.5 mg daily), who had LDL-C levels ≥80 mg/dL. They were randomly allocated to a group that received add-on therapy with ezetimibe at 10 mg/day (combination group, n = 40) or an increase of the rosuvastatin dose to 5 mg/day (dose escalation group, n = 39). These two groups were compared at baseline and after 12 weeks of treatment. RESULTS The percent change of LDL-C was -31% in the combination group and -12% in the dose escalation group. Both groups showed a significant decrease, but the decrease was greater in the combination group. In both groups, there was a significant decrease in the levels of small dense LDL-C, oxidized LDL and remnant-like lipoprotein cholesterol. For all of these parameters, the percent changes were greater in the combination group. Only the combination group showed a significant decrease of triglycerides. Multivariate analysis was performed to identify factors associated with reaching an LDL-C level <80 mg/dL. As a result, add-on therapy with ezetimibe was extracted as a factor related to improvement of LDL-C. CONCLUSIONS Compared with increasing the dose of rosuvastatin, the combination of rosuvastatin and ezetimibe not only achieves quantitative but also qualitative improvement of serum lipid levels in type 2 diabetic patients, suggesting that this combination could suppress the progression of atherosclerosis. TRIAL REGISTRATION UMIN000011005.
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Affiliation(s)
- Keiichi Torimoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Hiroko Mori
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Maiko Hajime
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Kenichi Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Manabu Narisawa
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Sunao Yamamoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Tadashi Arao
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | | | | | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
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9
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Machorro-Méndez I, Hernández-Mendoza A, Cardenia V, Rodriguez-Estrada M, Lercker G, Spinelli F, Cellini A, García H. Assessment of in vitro
removal of cholesterol oxidation products by Lactobacillus casei
ATCC334. Lett Appl Microbiol 2013; 57:443-50. [DOI: 10.1111/lam.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 07/08/2013] [Accepted: 07/08/2013] [Indexed: 12/18/2022]
Affiliation(s)
| | | | - V. Cardenia
- Interdepartmental Centre for Agri-food Industrial Research; Alma Mater Studiorum-University of Bologna; Cesena (FC) Italy
| | - M.T. Rodriguez-Estrada
- Department of Agricultural and Food Sciences; Alma Mater Studiorum-University of Bologna; Bologna Italy
| | - G. Lercker
- Department of Agricultural and Food Sciences; Alma Mater Studiorum-University of Bologna; Bologna Italy
| | - F. Spinelli
- Department of Agricultural Sciences; Alma Mater Studiorum-University of Bologna; Bologna Italy
| | - A. Cellini
- Department of Agricultural Sciences; Alma Mater Studiorum-University of Bologna; Bologna Italy
| | - H.S. García
- UNIDA-Instituto Tecnológico de Veracruz; Veracruz México
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10
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Terunuma S, Kumata N, Osada K. Ezetimibe impairs uptake of dietary cholesterol oxidation products and reduces alterations in hepatic cholesterol metabolism and antioxidant function in rats. Lipids 2013; 48:587-95. [PMID: 23588779 DOI: 10.1007/s11745-013-3790-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/22/2013] [Indexed: 12/27/2022]
Abstract
Dietary cholesterol oxidation products (COP) induce various adverse effects, including development of atherosclerosis, modulation of lipid metabolism, and unfavorable changes in the antioxidant system. Therefore, we examined the effects of ezetimibe, a cholesterol absorption inhibitor on hepatic cholesterol metabolism and down-regulation of the antioxidant system in rats fed COP. Rats were fed a purified diet containing 0.3 % COP with or without ezetimibe (0.07 mg/100 g body weight) for 27 days. Levels of COP in both the plasma and liver were lowered by ezetimibe through promotion of COP excretion into the feces. Reflecting this effect, an increase in the arteriosclerotic index and a reduction in the mRNA expression of hepatic cholesterol biosynthesis transcripts by dietary COP were observed. Moreover, the ferric reducing ability of the plasma also was significantly higher in rats fed COP plus ezetimibe than in those fed COP alone. Finally, we also observed that ezetimibe enhanced the down-regulation of hepatic fatty acid synthesis in rats fed COP. Thus, ezetimibe, which inhibits the absorption of dietary COP from the small intestine, may exert preventive effects on dietary COP-induced disruption of cholesterol and fatty acid metabolism in the liver and down-regulation of the antioxidant system.
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Affiliation(s)
- Shoichiro Terunuma
- Department of Agricultural Chemistry, School of Agriculture, Meiji University, 1-1-1 Higashimita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
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11
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Naples M, Baker C, Lino M, Iqbal J, Hussain MM, Adeli K. Ezetimibe ameliorates intestinal chylomicron overproduction and improves glucose tolerance in a diet-induced hamster model of insulin resistance. Am J Physiol Gastrointest Liver Physiol 2012; 302:G1043-52. [PMID: 22345552 PMCID: PMC4380478 DOI: 10.1152/ajpgi.00250.2011] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Ezetimibe is a cholesterol uptake inhibitor that targets the Niemann-Pick C1-like 1 cholesterol transporter. Ezetimibe treatment has been shown to cause significant decreases in plasma cholesterol levels in patients with hypercholesterolemia and familial hypercholesterolemia. A recent study in humans has shown that ezetimibe can decrease the release of atherogenic postprandial intestinal lipoproteins. In the present study, we evaluated the mechanisms by which ezetimibe treatment can lower postprandial apoB48-containing chylomicron particles, using a hyperlipidemic and insulin-resistant hamster model fed a diet rich in fructose and fat (the FF diet) and fructose, fat, and cholesterol (the FFC diet). Male Syrian Golden hamsters were fed either chow or the FF or FFC diet ± ezetimibe for 2 wk. After 2 wk, chylomicron production was assessed following intravenous triton infusion. Tissues were then collected and analyzed for protein and mRNA content. FFC-fed hamsters treated with ezetimibe showed improved glucose tolerance, decreased fasting insulin levels, and markedly reduced circulating levels of TG and cholesterol in both the LDL and VLDL fractions. Examination of triglyceride (TG)-rich lipoprotein (TRL) fractions showed that ezetimibe treatment reduced postprandial cholesterol content in TRL lipoproteins as well as reducing apoB48 content. Although ezetimibe did not decrease TRL-TG levels in FFC hamsters, ezetimibe treatment in FF hamsters resulted in decreases in TRL-TG. Jejunal apoB48 protein expression was lower in ezetimibe-treated hamsters. Reductions in jejunal protein levels of scavenger receptor type B-1 (SRB-1) and fatty acid transport protein 4 were also observed. In addition, ezetimibe-treated hamsters showed significantly lower jejunal mRNA expression of a number of genes involved in lipid synthesis and transport, including srebp-1c, sr-b1, ppar-γ, and abcg1. These data suggest that treatment with ezetimibe not only inhibits cholesterol uptake, but may also alter intestinal function to promote improved handling of dietary lipids and reduced chylomicron production. These, in turn, promote decreases in fasting and postprandial lipid levels and improvements in glucose homeostasis.
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Affiliation(s)
- Mark Naples
- 1Molecular Structure and Function, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada;
| | - Chris Baker
- 1Molecular Structure and Function, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada;
| | - Marsel Lino
- 1Molecular Structure and Function, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada;
| | | | | | - Khosrow Adeli
- 1Molecular Structure and Function, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada;
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12
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Sato K, Nakano K, Katsuki S, Matoba T, Osada K, Sawamura T, Sunagawa K, Egashira K. Dietary Cholesterol Oxidation Products Accelerate Plaque Destabilization and Rupture Associated with Monocyte Infiltration/Activation via the MCP-1-CCR2 Pathway in Mouse Brachiocephalic Arteries: Therapeutic Effects of Ezetimibe. J Atheroscler Thromb 2012; 19:986-98. [DOI: 10.5551/jat.13391] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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13
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Kostapanos MS, Spyrou AT, Tellis CC, Gazi IF, Tselepis AD, Elisaf M, Liberopoulos EN. Ezetimibe Treatment Lowers Indicators of Oxidative Stress in Hypercholesterolemic Subjects with High Oxidative Stress. Lipids 2011; 46:341-8. [PMID: 21359598 DOI: 10.1007/s11745-011-3539-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 02/04/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
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14
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Ueda SI, Miyake I, Takata K, Shimizu N, Shirotani K, Ishida S, Yonemitsu K, Maeyama T, Saito F, Saito H, Yamagishi SI. Ezetimibe, an inhibitor of intestinal cholesterol absorption, decreases serum level of malondialdehyde-modified low-density lipoprotein in patients with hypercholesterolemia. Int J Cardiol 2011; 146:420-1. [DOI: 10.1016/j.ijcard.2010.10.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 10/23/2010] [Indexed: 11/29/2022]
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15
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Ahmed MH, Byrne CD. Potential therapeutic uses for ezetimibe beyond lowering LDL-c to decrease cardiovascular events. Diabetes Obes Metab 2010; 12:958-66. [PMID: 20880342 DOI: 10.1111/j.1463-1326.2010.01261.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ezetimibe is a relatively new drug that inhibits the absorption of dietary cholesterol in the small intestine. It is a low density lipoprotein-cholesterol (LDL-C) lowering medication that acts directly on the intestine by inhibiting Niemann-Pick C1 Like1 (NPC1L1). Recently, results of the ARBITER 6-HALTS trial (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies) and the ENHANCE trial (Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression) showed that ezetimibe had no effect on atherosclerosis despite producing a marked decrease in LDL-C. Recent studies show a potential benefit of ezetimibe in treating insulin resistance, non-alcoholic fatty liver disease (NAFLD), gallstones and dyslipidaemia associated with chronic renal failure and organ transplantation. All of these conditions are known to be associated with an increase in risk of cardiovascular disease (CVD) and further studies are needed to assess the potential benefits of ezetimibe in these therapeutics areas.
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Affiliation(s)
- M H Ahmed
- Chemical Pathology Department, Southampton University Hospitals NHS Trust, Southampton, UK
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16
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Berrodin TJ, Shen Q, Quinet EM, Yudt MR, Freedman LP, Nagpal S. Identification of 5α,6α-Epoxycholesterol as a Novel Modulator of Liver X Receptor Activity. Mol Pharmacol 2010; 78:1046-58. [DOI: 10.1124/mol.110.065193] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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17
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Miyashita Y, Endo K, Saiki A, Ban N, Nagumo A, Yamaguchi T, Kawana H, Nagayama D, Ohira M, Oyama T, Shirai K. Effect of ezetimibe monotherapy on lipid metabolism and arterial stiffness assessed by cardio-ankle vascular index in type 2 diabetic patients. J Atheroscler Thromb 2010; 17:1070-6. [PMID: 20644331 DOI: 10.5551/jat.4465] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM High cholesterol absorption in the small intestine has been proposed to be a risk factor of atherosclerosis. In this study, we evaluated the effect of ezetimibe monotherapy on arterial stiffness in type 2 diabetic patients. METHODS Forty type 2 diabetes mellitus patients with high serum low-density lipoprotein cholesterol (LDL-C) were enrolled and treated with ezetimibe 10 mg/day for 6 months. HbA1c, serum lipids, remnant-like particle-cholesterol (RLP-C), serum lipoprotein lipase mass (LPL mass) and the cardio-ankle vascular index (CAVI) were measured before and after ezetimibe treatment. RESULTS After 6 months of ezetimibe treatment, significant decreases in LDL-C, RLP-C and CAVI were observed. In the group that achieved the LDL-C goal of <120 mg/dL after 6 months of ezetimibe treatment, the pretreatment CAVI was markedly high, and CAVI decreased significantly after ezetimibe treatment. CONCLUSIONS In type 2 diabetic patients, ezetimibe monotherapy may have the potential to ameliorate arterial stiffness in addition to lowering LDL-C and RLP-C.
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Affiliation(s)
- Yoh Miyashita
- Departments of Internal Medicine, Sakura Medical Center, School of Medicine, Toho University, 564-1 Shimoshizu, Chiba, Japan.
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Chan DC, Watts GF, Gan SK, Ooi EMM, Barrett PHR. Effect of ezetimibe on hepatic fat, inflammatory markers, and apolipoprotein B-100 kinetics in insulin-resistant obese subjects on a weight loss diet. Diabetes Care 2010; 33:1134-9. [PMID: 20185740 PMCID: PMC2858190 DOI: 10.2337/dc09-1765] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease is highly prevalent in obese and type 2 diabetic individuals and is strongly associated with dyslipidemia and inflammation. Weight loss and/or pharmacotherapy are commonly used to correct these abnormalities. RESEARCH DESIGN AND METHODS We performed a 16-week intervention trial of a hypocaloric, low-fat diet plus 10 mg/day ezetimibe (n = 15) versus a hypocaloric, low-fat diet alone (n = 10) on intrahepatic triglyceride (IHTG) content, plasma high sensitivity-C-reactive protein (hs-CRP), adipocytokines, and fetuin-A concentrations and apolipoprotein (apo)B-100 kinetics in obese subjects. ApoB-100 metabolism was assessed using stable isotope tracer kinetics and compartmental modeling; liver and abdominal fat contents were determined by magnetic resonance techniques. RESULTS Both weight loss and ezetimibe plus weight loss significantly (all P < 0.05) reduced body weight, visceral and subcutaneous adipose tissues, insulin resistance and plasma triglycerides, VLDL-apoB-100, apoC-III, fetuin-A, and retinol-binding protein-4 and increased plasma adiponectin concentrations. Compared with weight loss alone, ezetimibe plus weight loss significantly (all P < 0.05) decreased IHTG content (-18%), plasma hs-CRP (-53%), interleukin-6 (-24%), LDL cholesterol (-18%), campesterol (-59%), and apoB-100 (-14%) levels, with a significant increase in plasma lathosterol concentrations (+43%). The LDL-apoB-100 concentration also significantly fell with ezetimibe plus weight loss (-12%), chiefly owing to an increase in the corresponding fractional catabolic rate (+29%). The VLDL-apoB-100 secretion rate fell with both interventions, with no significant independent effect of ezetimibe. CONCLUSIONS Addition of ezetimibe to a moderate weight loss diet in obese subjects can significantly improve hepatic steatosis, inflammation, and LDL-apoB-100 metabolism.
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Affiliation(s)
- Dick C Chan
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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Kalogirou M, Tsimihodimos V, Elisaf M. Pleiotropic effects of ezetimibe: do they really exist? Eur J Pharmacol 2010; 633:62-70. [PMID: 20152830 DOI: 10.1016/j.ejphar.2010.02.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 01/07/2010] [Accepted: 02/02/2010] [Indexed: 02/07/2023]
Abstract
Ezetimibe represents a new lipid lowering agent which inhibits cholesterol absorption. It effectively reduces low-density lipoprotein cholesterol when administered either alone or in combination with statins. However, its effect on cardiovascular mortality remains under question since it failed to demonstrate any significant changes in the primary endpoints of the recently published ENHANCE and SEAS studies. A possible explanation for this unsuccessful outcome is that ezetimibe lacks pleiotropic effects. This article aims to review the potential pleiotropic effects of the drug mainly on inflammation markers, lipoprotein subfractions and endothelial function.
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Affiliation(s)
- Michalis Kalogirou
- Department of Internal Medicine, University of Ioannina, Ioannina, Greece
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Araoka T, Takeoka H, Abe H, Kishi S, Araki M, Nishioka K, Ikeda M, Mazaki T, Ikemura S, Kondo M, Hoshina A, Nagai K, Mima A, Murakami T, Mimura R, Oka K, Saito T, Doi T. Early diagnosis and treatment may prevent the development of complications in an adult patient with glycogen storage disease type Ia. Intern Med 2010; 49:1787-92. [PMID: 20720360 DOI: 10.2169/internalmedicine.49.3425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Type Iota(a) glycogen storage disease (GSD Iota(a)) is caused by the deficiency of glucose-6-phosphatase activity, which results in metabolic disorder and organ failure, including renal failure. GSD Iota(a) patients are generally diagnosed at a median age of 6 months. However, we report a 20-year-old Japanese female with newly diagnosed GSD Iota(a) . The renal disorder of GSD Iota(a) is considered to be produced by glomerular hyperfiltration, TGF-beta expression which is induced by renin-angiotensin-aldosterone system (RAS) and uric acid, and the increase in both small dense LDL and modified LDL which is characteristic of GSD Iota(a) as well as hypertriglyceridemia. With the administration of intensive therapies, including angiotensin type 1-receptor blocker and some lipid lowering drugs, along with traditional dietary therapy, daily proteinuria of the patient improved from 2.1 g to 0.78 g. Although the patients of GSD Iota(a) should receive an early and accurate diagnosis and effective therapies before the age of 1 year, the combination of traditional dietary therapies and intensive therapies may have therapeutic potential for the complications of adult patients. In this report, we describe the management of renal disease and the characteristic features of this metabolic disorder.
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Affiliation(s)
- Toshikazu Araoka
- Department of Nephrology, Graduate School of Medicine, University of Tokushima, Tokushima, Japan
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Nozue T, Michishita I, Mizuguchi I. Effects of Ezetimibe on Remnant-Like Particle Cholesterol, Lipoprotein (a), and Oxidized Low-Density Lipoprotein in Patients with Dyslipidemia. J Atheroscler Thromb 2010; 17:37-44. [DOI: 10.5551/jat.1651] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Patients with dyslipidemia and advanced renal failure are at markedly increased risk of cardiovascular morbidity and mortality. We evaluated the efficacy and safety of ezetimibe administration to patients with endstage renal failure (ESRF) who are undergoing hemodialysis. Ezetimibe at 10 mg/day was given to 20 patients for 12 weeks. Efficacy was determined by monitoring lipids, and safety was determined by monitoring clinical and laboratory parameters. We also evaluated the effects of ezetimibe on surrogate markers of cholesterol absorption and synthesis. Compared to baseline values, LDL-cholesterol (LDL-C) was reduced by 24.9% (p<0.005) after 12 weeks of ezetimibe administration. Treatment with ezetimibe did not change HDL-cholesterol, triglyceride and HbA1c values but caused a significant reduction in remnant like particles-cholesterol (RLP-C, p<0.05) and high-sensitive C-reactive protein (hsCRP, p<0.05). Ezetimibe therapy decreased cholesterol absorption markers (campesterol and sitosterol) and increased a marker of cholesterol synthesis (lathosterol). A highly significant correlation was observed between alterations in LDL-C and campesterol levels in response to ezetimibe therapy. No patients reported musculoskeletal symptoms. None of the patients experienced elevations in their creatine kinase or liver transaminase levels. Ezetimibe not only reduced serum LDL-C, but also RLP-C and hsCRP, in ESRF patients. Inhibition of cholesterol absorption by ezetimibe is an important therapeutic option in these patients due to its efficacy and safety.
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Affiliation(s)
- Sachiko Hattori
- Endocrinology and Metabolism, Tsunemicho Hospital, Ashikaga, Tochigi, Japan.
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Abstract
Ezetimibe is a new lipid-lowering agent that inhibits intestinal absorption of dietary cholesterol. It substantially lowers low-density lipoprotein cholesterol levels when used alone or in combination with statins. However, its effect on cardiovascular mortality remains unknown. We reviewed peer-reviewed published literature on the effect of ezetimibe on different phases of atherosclerosis. MEDLINE, EMBASE, BIOSIS, and other Web of Knowledge databases were searched for relevant abstracts and articles published in the English language that compared ezetimibe and statins as modulators of atherosclerosis. On the basis of the available evidence, ezetimibe appears to reduce inflammation when used in combination with statins, but its effect on endothelial function is mixed and less clear. The effect of ezetimibe on coronary disease progression or prevention of cardiovascular events is currently unknown. Use of ezetimibe as a second- or third-line agent to achieve low-density lipoprotein cholesterol treatment goals seems appropriate on the basis of the available evidence.
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Affiliation(s)
| | | | | | - Randal J. Thomas
- Individual reprints of this article are not available. Address correspondence to Randal J. Thomas, MD, MS, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905 ().
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Perez-Martinez P, Corella D, Shen J, Arnett DK, Yiannakouris N, Tai ES, Orho-Melander M, Tucker KL, Tsai M, Straka RJ, Province M, Kai CS, Perez-Jimenez F, Lai CQ, Lopez-Miranda J, Guillen M, Parnell LD, Borecki I, Kathiresan S, Ordovas JM. Association between glucokinase regulatory protein (GCKR) and apolipoprotein A5 (APOA5) gene polymorphisms and triacylglycerol concentrations in fasting, postprandial, and fenofibrate-treated states. Am J Clin Nutr 2009; 89:391-9. [PMID: 19056598 PMCID: PMC2647710 DOI: 10.3945/ajcn.2008.26363] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hypertriglyceridemia is a risk factor for cardiovascular disease. Variation in the apolipoprotein A5 (APOA5) and glucokinase regulatory protein (GCKR) genes has been associated with fasting plasma triacylglycerol. OBJECTIVE We investigated the combined effects of the GCKR rs780094C-->T, APOA5 -1131T-->C, and APOA5 56C-->G single nucleotide polymorphisms (SNPs) on fasting triacylglycerol in several independent populations and the response to a high-fat meal and fenofibrate interventions. DESIGN We used a cross-sectional design to investigate the association with fasting triacylglycerol in 8 populations from America, Asia, and Europe (n = 7,730 men and women) and 2 intervention studies in US whites (n = 1,061) to examine postprandial triacylglycerol after a high-fat meal and the response to fenofibrate. We defined 3 combined genotype groups: 1) protective (homozygous for the wild-type allele for all 3 SNPs); 2) intermediate (any mixed genotype not included in groups 1 and 3); and 3) risk (carriers of the variant alleles at both genes). RESULTS Subjects within the risk group had significantly higher fasting triacylglycerol and a higher prevalence of hypertriglyceridemia than did subjects in the protective group across all populations. Moreover, subjects in the risk group had a greater postprandial triacylglycerol response to a high-fat meal and greater fenofibrate-induced reduction of fasting triacylglycerol than did the other groups, especially among persons with hypertriglyceridemia. Subjects with the intermediate genotype had intermediate values (P for trend <0.001). CONCLUSIONS SNPs in GCKR and APOA5 have an additive effect on both fasting and postprandial triacylglycerol and contribute to the interindividual variability in response to fenofibrate treatment.
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Affiliation(s)
- Pablo Perez-Martinez
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
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Ono K, Takaishi M. Effects of Rosuvastatin on Oxidized-LDL Cholesterol in the Elderly. J Atheroscler Thromb 2009; 16:135-6. [DOI: 10.5551/jat.e778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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The intestine as a regulator of cholesterol homeostasis in diabetes. ATHEROSCLEROSIS SUPP 2008; 9:27-32. [PMID: 18693145 DOI: 10.1016/j.atherosclerosissup.2008.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 02/27/2008] [Accepted: 05/13/2008] [Indexed: 11/24/2022]
Abstract
The chylomicron influences very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) composition but itself is atherogenic. Thus abnormalities of chylomicron production are of interest particularly in conditions such as diabetes which confer major cardiovascular risk. Intestinal function is abnormal in diabetes and is a major cause of the dyslipidaemia found in this condition. Studies have suggested that cholesterol absorption is decreased in diabetes and cholesterol synthesis increased. Molecular mechanisms involved in insulin resistance in the intestine and its effect on cholesterol homeostasis in diabetes are described. Abnormalities in triglyceride synthesis and alterations genes regulating cholesterol absorption and intestinal synthesis are discussed. In particular, increase in apolipoprotein B48 synthesis has been demonstrated in animal models of diabetes and insulin resistance. Intestinal mRNA expression of Niemann Pick C1-like 1, protein is increased in both experimental and human diabetes suggesting that an increase in cholesterol transportation does occur. mRNA expression of the ATP binding cassette proteins (ABC) G5 and G8, two proteins working in tandem to excrete cholesterol have been shown to be decreased suggesting increased delivery of cholesterol for absorption. Expression of microsomal triglyceride transfer protein, which assembles the chylomicron particle, is increased in diabetes leading to increase in both number and cholesterol content. In conclusion, diabetes is associated with considerable dysfunction of the intestine leading to abnormal chylomicron composition which may play a major part in the premature development of atherosclerosis.
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Davis HR, Basso F, Hoos LM, Tetzloff G, Lally SM, Altmann SW. Cholesterol homeostasis by the intestine: lessons from Niemann-Pick C1 Like 1 [NPC1L1). ATHEROSCLEROSIS SUPP 2008; 9:77-81. [PMID: 18585981 DOI: 10.1016/j.atherosclerosissup.2008.05.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 02/14/2008] [Accepted: 05/13/2008] [Indexed: 01/07/2023]
Abstract
Ezetimibe is a selective cholesterol absorption inhibitor, which potently inhibits the uptake and absorption of biliary and dietary cholesterol from the small intestine without affecting the absorption of fat-soluble vitamins, triglycerides or bile acids. Identification and characterization of Niemann-Pick C1 Like 1 (NPC1L1) has established NPC1L1 as an essential protein in the intestinal cholesterol absorption process. While otherwise phenotypically normal, Npc1l1 null mice exhibit a significant reduction in the intestinal uptake and absorption of cholesterol and phytosterols. Characterization of the NPC1L1 pathway revealed that ezetimibe specifically binds to NPC1L1 and inhibits its sterol transport function. Npc1l1 null mice were resistant to diet-induced hypercholesterolemia, and when crossed with apoE null mice, were completely resistant to the development of atherosclerosis. In Npc1l1/apoE null mice or apoE null mice treated with ezetimibe plasma cholesterol levels were reduced primarily in the apoB48 containing chylomicron remnant lipoproteins relative to untreated apoE null mice. SR-B1 has been proposed to play a role in intestinal cholesterol uptake, but in Npc1l1/SR-B1 double null mice intestinal cholesterol absorption was not different than Npc1l1 null alone mice. Therefore, NPC1L1 is the critical intestinal sterol transporter which influences whole body cholesterol homeostasis, and is the molecular target of ezetimibe.
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Affiliation(s)
- Harry R Davis
- Department of Cardiovascular/Metabolic Disease, Schering-Plough Research Institute, K15-2-2600, 2015 Galloping Hill Road, Kenilworth, NJ 07033, USA.
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Bays HE, Neff D, Tomassini JE, Tershakovec AM. Ezetimibe: cholesterol lowering and beyond. Expert Rev Cardiovasc Ther 2008; 6:447-70. [PMID: 18402536 DOI: 10.1586/14779072.6.4.447] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ezetimibe is a cholesterol absorption inhibitor that blocks the intestinal absorption of both biliary and dietary cholesterol. It appears to exert its effect by blocking intestinal sterol transporters, specifically Niemann-Pick C1-like 1 proteins, thereby inhibiting the intestinal absorption of cholesterol, phytosterols and certain oxysterols. Ezetimibe monotherapy and in combination with statin therapy is primarily indicated for lowering LDL-cholesterol levels. In addition, it may favorably affect other parameters that could potentially further reduce atherosclerotic coronary heart disease risk, such as raising HDL-cholesterol and lowering levels of triglycerides, non-HDL-cholesterol, apolipoprotein B and remnant-like particle cholesterol. Further effects of ezetimibe include a reduction in circulating phytosterols and oxysterols and, when used in combination with statins, a reduction in high-sensitivity C-reactive protein. The clinical significance of the LDL-cholesterol lowering and other effects of ezetimibe is being evaluated in clinical outcome studies.
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Affiliation(s)
- Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA.
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