Comparison of the effect of rosuvastatin versus rosuvastatin/ezetimibe on markers of inflammation in patients with acute myocardial infarction

Statins lower low‑density lipoprotein cholesterol (LDL‑C) and high‑sensitivity C‑reactive protein (hsCRP), and the addition of ezetimibe to statins further reduces LDL‑C and hsCRP. Lipoprotein‑associated phospholipase A2 (Lp‑PLA2) is a potentially important pathogenic factor participating in the progression of atherosclerosis. The aim of current study was to investigate how the addition of ezetimibe to rosuvastatin treatment affects reductions in LDL‑C, hsCRP and Lp‑PLA2 in patients with acute myocardial infarction (AMI). A total of 135 patients were enrolled in the study within 24 h of AMI, and were randomized to receive 10 mg rosuvastatin or 10 mg rosuvastatin plus 10 mg ezetimibe daily. HsCRP, Lp‑PLA2, total cholesterol (TC), triglycerides (TG), LDL‑C and high‑density lipoprotein cholesterol (HDL‑C) were determined at baseline and after 1, 3, 6 and 12 months of treatment. The addition of ezetimibe to rosuvastatin led to greater reduction of LDL‑C compared with rosuvastatin monotherapy (from 3.00 to 1.19 mmol/l vs. 2.93 to 1.49 mmol/l, respectively; P<0.05), as well as reduced levels of hsCRP (from 5.15 to 0.68 mg/l vs. 4.33 to 1.49 mg/l, respectively; P<0.05) and Lp‑PLA2 (from 333.13 to 79.07 mg/l vs. 327.95 to 123.62 mg/l, respectively; P<0.05). A positive association was identified between reductions of Lp‑PLA2 and the changes of LDL‑C (r=0.367; P=0.002). However, no significant correlation was observed between changes in Lp‑PLA2 and hsCRP (r=0.264; P=0.512). The values of hsCRP and Lp‑PLA2 appeared to increase during the first week after randomization, but dropped steeply to a lower level and remained stable thereafter. In conclusion, the addition of ezetimibe to rosuvastatin was demonstrated to further reduce LDL‑C, hsCRP and Lp‑PLA2 compared with rosuvastatin monotherapy in patients with AMI.