Why the study?
Does combination therapy with simvastatin and ezetimibe reduce biomarkers of inflammation and platelet activity compared to simvastatin monotherapy in aspirin-naive patients with metabolic syndrome?
Does combination therapy with simvastatin and ezetimibe reduce biomarkers of inflammation and platelet activity compared to simvastatin monotherapy in aspirin-naive patients with metabolic syndrome?
Adding ezetimibe to simvastatin improves indices of platelet reactivity and inflammation beyond statin monotherapy in patients with metabolic syndrome.
Supports ezetimibe addition to simvastatin for greater platelet and inflammatory marker reduction in metabolic syndrome; extends RCT evidence on combination effects beyond statin monotherapy.
In a randomized, double-blind, crossover study of 15 aspirin-naive patients (mean age 48.8 ± 10.2 years) with the metabolic syndrome, statin monotherapy (simvastatin 40 mg daily) was compared to combination therapy (simvastatin 40 mg and ezetimibe 10 mg daily) on biomarkers of inflammation and platelet activity. The addition of ezetimibe to simvastatin over a 4-week period was associated with reduced expression of CD141 (thrombomodulin; p = 0.02), platelet endothelial cell adhesion molecule (p < 0.0001) and CD51/61 (vitronectin receptor; p = 0.048) compared to statin monotherapy. Ezetimibe added to simvastatin improves several indices of platelet reactivity beyond statin monotherapy. However, the clinical relevance of these findings await results of the IMPROVE-IT trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).
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Miller et al. (2013) studied this question.
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