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Inflammation, Vol. 30, No. 6, December 2007 (# 2007)DOI: 10.1007/s10753-007-9041-3 The Effects of High Dose Pravastatin and Low DosePravastatin and Ezetimibe Combination Therapy on Lipid,Glucose Metabolism and Inflammation Necati Dagli,1,2 Mustafa Yavuzkir,1 and Ilgin Karaca1 Objective. Coronary artery disease (CAD) is presently the major cause of mortality and morbidity. Anti-hyperlipidemic treatment is one of the main treatment steps in the management of CAD. Statins are thecornerstones in this treatment. Ezetimibe can be reliably used, when statins prove ineffective in treatment,or to reduce their side effects. In the present study we examined the effects of high-dose pravastatin (40 mg)and low-dose pravastatin (10 mg) + ezetimibe (10 mg) combination therapy on lipid and glucose mechanism,as well as inflammation.
Methods. This study registered 100 cases. Of the cases, 50 [57.1 T 11.1 years (24 (48%) females and 26(52%) males)] were administered 40 mg/day pravastatin (group 1) and 50 [53.2 T 12.2 years (27 (54%)females and 23 (46%) males)] were administered 10 mg pravastatin + 10 mg ezetimibe (group 2).
Results. In group 1, total cholesterol fell from 231.1 T 83.5 mg/dl to 211.3 T 37.2 mg/dl (p = 0.03), triglyceridefrom 243.5 T 96.8 mg/dl to 190.9 T 55.2 mg/dl (p = 0.003), and LDL cholesterol from 165.7 T 29.7 mg/dl to133.4 T 26.6 mg/dl (p = 0.02). In group 2, total cholesterol dropped from 250.9 T 51.8 mg/dl to 187.9 T 34.9mg/dl (p = 0.001), triglyceride from 270.3 T 158.9 mg/dl to 154.6 T 60.7 mg/dl (p = 0.001), and LDLcholesterol from 158.1 T 47.5 mg/dl to 116.9 T 26.4 mg/dl (p = 0.001). Insulin resistance decreased from4.05 T 2.31 to 3.16 T 1.90 (p=0.07) in group 1 and from 2.96 T 1.50 to 2.05 T 0.55 (p=0.009) in group 2.
High sensitive C-reactive protein fell from 6.69 T 6.11 mg/l to 3.02 T 1.70 mg/l (p=0.01) in group 1 and from6.36 T 2.06 mg/l to 2.68 T 1.69 mg/l (p=0.001) in group 2.
Conclusion. Both therapy regimes are effective. However, we found that low-dose pravastatin and ezetimibecombination therapy is more effective than high-dose pravastatin therapy on lipid metabolism, glucose metab-olism and inflammation.
KEY WORDS: ezetimibe; pravastatin; hyperlipidemia; inflammation; insulin resistance.
ing aim of primary and secondary prevention isrestoration of elevated LDLYcholesterol (LDLYC) Coronary heart diseases (CAD) are among impor- It is known that the highest benefit is reaped from tant causes of mortality and morbidity, despite the aggressive LDLYC treatment in coronary artery disease.
recent developments Hypercholesterolemia, inflam- However, high-dose statin monotherapy either proves mation and insulin resistance have a significant part in ineffective or does not bring about the targeted lipid the development and progression of CAD. The forego- Lipid-lowering therapy is a cornerstone in prevent- ing coronary artery disease, particularly in high-risk 1 Departments of Cardiology, Firat University, School of Medicine, patients and coroner artery disease .The 3-hydroxy-3- methylglutaryl coenzyme A (HMGYCoA) reductase To whom correspondence should be addressed at Firat (Euphrates) inhibitors (statins) are the most potent and commonly ¨ niversitesi, Firat Tip Merkezi, Kardiyoloji Anabilim Dali, 23119, Elazig, Turkey. E-mail: mustafanecati46@hotmail.com prescribed drugs for the treatment of hypercholesterol- 0360-3997/07/0600-0230/0 # 2007 Springer Science + Business Media, LLC

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