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Review
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Korean J Med. 2006;71(1):147-147.
- The effectiveness and safety of cholesterol dual inhibition in acute myocardial infarction.
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이미연&#;배장환&#;황경국&#;김동운&#;조명찬
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- The effectiveness and safety of cholesterol dual inhibition in acute myocardial infarction.
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고려의대 구로병원 내과학 교실
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- Abstract
- Background and objectives
: Statin (HMGCoA reductase inhibitor) have been used the first choice for cholesterol reduction
in cardiovascular disease patients. Recently, the intestinal selective cholesterol inhibitor, ezetimibe, was introduced in clinical field.
Dual cholesterol inhibition, ie statin and ezetimibe dual therapy is very effective total cholesterol (TC) and LDL-cholesterol
(LDL-C) reduction. But, upto now there is few data of effectiveness and safety profile of cholesterol dual inhibition of ezetimibe
addition on the base of statin. We analyzed retrospectively the cholesterol and safety profile of dual cholesterol inhibition in acute
myocardial infarction patients. Method : This analysis was performed retrospectively. After the successful coronary
revascularizaton in acute myocardial infarction, newly detected dyslipidemia 73 patients (LDL-C > 100 mg/dL) was enrolled for
this study. Dual inhibition group (Group A, mainly 20 mg simvastatin or 10 mg atorvastatin with ezetimibe 10 mg) was
composed with 15 patients and other 58 patients was initiated with mainly 20 mg simvastatin or 10 mg atorvastatin single
therapy (Group B). 1, 2, 3 and 6 months lipid profile and safety profiles were analyzed. Results : Between dual inhibition and
single therapy group, BMI, prevalence of hypertension, diabetes, smoker were comparable. Even though TC (212.4 ¡¾26.5 vs 199.5
¡¾38.1 mg/dL) and LDL-C (145.3¡¾21.5 vs 133.3¡¾29.8 mg/dL) was higher in group A, 1 month later, TC reduction percent was
higher in Group A (27.4% vs 17.1%, p< 0.03). TC (153.4 vs 166.2 mg/dL) and LDL-C (95.4 vs 98.4 mg/dL) was comparable in
both group. 16% (9/58 patients) of group B patients were converted to dual inhibition therapy due to failure of 100 mg/dL LDL-C
achievement. Only 1 patient in each group showed AST/ALT elevation (upto 2 times of UNL) and no myopathic event observed.
Conclusion
: Even though higher baseline TC, LDL-C level, dual cholesterol inhibition showed effective TC and LDL-C control
and comparable safety profiles compare to single statin therapy in myocardial infarction with hyperlipidemic patients.
Keywords :
