Changes in lipoproteins associated with lipid-lowering and antiplatelet strategies in patients with acute myocardial infarction

Figures

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  Fig 1. Enrollment and flow of patients. From the total of 143 subjects assessed for eligibility, 14 were excluded due to inclusion or exclusion criteria and 6 did not complete the 6 months follow-up.

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  Fig 2. Graphical abstract.

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  Fig 3. Box-plot for phase shift (θ) at baseline (T0) and after six months (T6). (A) according to lipid-lowering and antiplatelet drugs; (B) for combined therapies. Simvastatin/ezetimibe (SIMVA/E), rosuvastatin (RSV), ticagrelor (TICA) and clopidogrel (CLOP). (*: significant difference, Wilcoxon signed rank test, **: significant difference, Mann-Whitney U test).

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  Fig 4. Correlations between absorbance at wavelength 484 nm and phase shift (θ) after six months of combined therapy (T6). (A) rosuvastatin-clopidogrel (RSV-CLOP); (B) rosuvastatin-ticagrelor (RSV-TICA); (C) simvastatin/ezetimibe-clopidogrel (SIMVA/E-CLOP); (D) simvastatin/ezetimibe-ticagrelor (SIMVA/E-TICA). Significant correlations were observed for all the combined therapies at T6 (Spearman rank test).

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  Fig 5. Box-plots for combined therapies at baseline (T0) and after six months (T6). (A) radius of the LDL particles RLDL; (B) relative electronic density contrast of the LDL particles |μLDL|. Simvastatin/ezetimibe (SIMVA/E), rosuvastatin (RSV), ticagrelor (TICA) and clopidogrel (CLOP). (*: significant difference, Wilcoxon signed rank test and **: significant difference, Kruskal-Wallis test with Dunn’s post-hoc test, p<0.05).

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  Fig 6. Classic lipid profile at baseline (T0) and after six months (T6). (A) Total cholesterol at T0 and at T6 with combined therapy. Significant decrease was observed with all the combined therapies. For rosuvastatin-clopidogrel (p = 7.4E-9); for rosuvastatin-ticagrelor (p = 3.7E-9); for simvastatin/ezetimibe-clopidogrel (p = 1.4E-8); and for simvastatin/ezetimibe-ticagrelor (p = 1.8E-9). (B) LDL-C at T0 and at T6 with combined therapy. Significant decrease was observed with all the combined therapies. For rosuvastatin-clopidogrel (p = 1.8E-9); for rosuvastatin-ticagrelor (p = 3.7E-9); for simvastatin/ezetimibe-clopidogrel (p = 5.9E-8); and for simvastatin/ezetimibe-ticagrelor (p = 4.6E-10). (C) Non-HDL-C at T0 and at T6 with combined therapy. Significant decrease was observed with all the combined therapies. For rosuvastatin-clopidogrel (p = 2.9E-8); for rosuvastatin-ticagrelor (p = 3.4E-9); for simvastatin/ezetimibe-clopidogrel (p = 2.9E-8); and for simvastatin/ezetimibe-ticagrelor (p = 4.6E-10). (D) HDL-C at T0 and at T6 with combined therapy. None of the combined therapies significantly changed HDL-C. For rosuvastatin-clopidogrel (p = 0.1580); for rosuvastatin-ticagrelor (p =…

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  Fig 7. LDL subfractions at baseline (T0) and after six months (T6). (A) Group rosuvastatin-ticagrelor (RSV/TICA). The combined therapy decreased the cholesterol content of large and buoyant LDL particles (LDL1 and LDL 2) (p<0.001), but not from the small and dense LDL particles (LDL3-LDL7). (B) Group rosuvastatin-clopidogrel (RSV/CLOP). The combined therapy decreased the cholesterol content of large and buoyant LDL particles (LDL1 and LDL 2,) (p<0.001) but not from the small and dense LDL particles (LDL3-LDL7). (C) Group simvastatin/ezetimibe-ticagrelor (SIMVA/E-TICA). The combined therapy decreased the cholesterol content of large and buoyant LDL particles (LDL1 and LDL 2) (p = 0.001), and also from the small and dense LDL particles (LDL3-LDL7) (p = 0.044). (D) Group simvastatin/ezetimibe-clopidogrel (SIMVA/E-CLOP). The combined therapy decreased the cholesterol content of large and buoyant LDL particles (LDL1 and LDL 2) (p = 0.028), but not from the small and dense LDL particles (LDL3-LDL7).