Background: Statins are frequently administered to reduce low-density lipoprotein cholesterol (LDL-C) and vascular\r\ninflammation, because LDL-C and high sensitive C-reactive protein (hs-CRP) are associated with high risk for\r\ncardiovascular events. When statins do not reduce LDL-C to desired levels in high-risk patients with coronary artery\r\ndisease (CAD), ezetimibe can be added or the statin dose can be increased. However, which strategy is more\r\neffective for treating patients with CAD has not been established. The present study compares anti-inflammatory\r\neffects and lipid profiles in patients with CAD and similar LDL-C levels who were treated by increasing the statin dose\r\nor by adding ezetimibe to the original rosuvastatin dose to determine the optimal treatment for such patients.\r\nMethods: 46 patients with high-risk CAD and LDL-C and hs-CRP levels of >70 mg/dL and >1.0 mg/L, respectively, that\r\nwere not improved by 4 weeks of rosuvastatin (2.5 mg/day) were randomly assigned to receive 10 mg (R10, n = 24) of\r\nrosuvastatin or 2.5 mg/day of rosuvastatin combined with 10 mg/day of ezetimibe (R2.5/E10, n = 22) for 12 weeks. The\r\nprimary endpoint was a change in hs-CRP.\r\nResults: Baseline characteristics did not significantly differ between the groups. At 12 weeks, LDL-C and inflammatory\r\nmarkers (hs-CRP, interleukin-6, tumour necrosis factor-alpha and pentraxin 3) also did not significantly differ between the\r\ntwo groups (LDL-C: R10 vs. R2.5/E10: -19.4 �± 14.2 vs. -22.4 �± 14.3 mg/dL). However, high-density lipoprotein cholesterol\r\n(HDL-C) was significantly improved in the R10, compared with R2.5/E10 group (4.6 �± 5.9 vs. 0.0 �± 6.7 mg/dL; p < 0.05).\r\nConclusion: Both enhanced therapies exerted similar anti-inflammatory effects under an equal LDL-C reduction in\r\npatients with high-risk CAD despite 2.5 mg/day of rosuvastatin. However, R10 elevated HDL-C more effectively\r\nthan R2.5/E10.
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