Efficacy of simvastatin or ezetimibe on tissue factor, von Willebrand's factor and C-reactive protein in patients with hypercholesterolaemia

Summary Background Statins have favourable effects on lipid profiles, decrease total mortality and have many pleiotropic effects. Aims To determine and compare the pleiotropic effects of simvastatin and ezetimibe in dyslipidaemic patients. Methods Forty-four patients (20 postmenopausal women) with low-density lipoprotein cholesterol >130 mg/dL (or >100 mg/dL in patients with coronary artery disease or its equivalent) were treated with simvastatin 10 mg daily ( n  = 21) or ezetimibe 10 mg daily ( n  = 23). In blood samples taken before and three months after treatment, we measured the concentration of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B, lipoprotein(a), homocysteine, tissue factor, von Willebrand's factor and C-reactive protein. Results Baseline lipid profiles and haematological variables were similar in both groups. Simvastatin and ezetimibe decreased the concentrations of total cholesterol (262 to 189 mg/dL, p p  = 0.001, respectively), low-density lipoprotein cholesterol (177 to 114 mg/dL, p p p  = 0.001 and 2.8 to 0.8 mg/dL, p  = 0.005, respectively). Simvastatin also reduced the concentration of apolipoprotein B (125 to 93 mg/dL, p Conclusion Both drugs improved lipid profiles and C-reactive protein concentration. However, no influence was found on tissue factor or von Willebrand's factor. Our results suggest that C-reactive protein lowering may occur in conjunction with low-density-lipoprotein cholesterol lowering and not through a specific statin pleiotropic anti-inflammatory effect.