The Effects of Statin Monotherapy and Low‐Dose Statin/Ezetimibe on Lipoprotein‐Associated Phospholipase A2

Background Many of the pleiotropic effects of statins remain to be elucidated. Hypothesis Different statin regimens with similar lipid‐lowering efficacy may have different effects on biomarkers of atherothrombosis including lipoprotein‐associated phospholipase A2 (Lp‐PLA2). Methods After a 4‐week dietary lead‐in, 82 hypercholesterolemic patients were randomized to 1 of 2 treatment groups: atorvastatin 20 mg or atorvastatin/ezetimibe 5 mg/5 mg. After 8 weeks of drug treatment, the groups were compared for percent change in lipid parameters, Lp‐PLA2, interleukin‐6 (IL‐6), monocyte chemoattractant protein‐1, and fibrinogen. Results Low‐density lipoprotein cholesterol (LDL‐C) lowering was comparable between the 2 groups (−47% ± 11% and −49% ± 7% in the atorvastatin and combination groups, respectively). Although Lp‐PLA2 was reduced in both groups, the reduction was greater in the atorvastatin group (−42% and −9% [median], respectively, P = 0.03). Although IL‐6 was decreased only in the atorvastatin group, IL‐6 changes were not significantly different between the 2 groups. The changes in monocyte chemoattractant protein‐1 and fibrinogen were similar in each group. Conclusions Atorvastatin monotherapy was stronger at reducing plasma Lp‐PLA2 than the low‐dose atorvastatin/ezetimibe combination after equivalent LDL‐C lowering. This result may provide evidence of potential statin effects beyond the lowering of LDL‐C. Copyright © 2011 Wiley Periodicals, Inc. This study was supported by a grant from the Ministry of Health and Welfare, Republic of Korea (A000385), a grant of the Seoul R&BD Program, Republic of Korea (10526), and a grant of the Korean Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085136). The authors have no other funding, financial relationships, or conflicts of interest to disclose.