The influence of statin monotherapy and statin-ezetimibe
combined therapy on FoxP3 and IL 10 mRNA expression
in patients with coronary artery disease

Background: The aim of lipid-lowering treatment is to reduce the risk for cardiovascular events. Patients not at target lipid levels while on hydroxymethylglutaryl coenzyme A reductase inhibitors (statin) monotherapy are at increased cardiovascular risk. Objective: To describe the impact of coadministration of ezetimibe with a statin on the estimated 10 year risk for coronary artery disease (E-RCAD) in patients with hypercholesterolemia and above-target low-density lipoprotein cholesterol (LDL-C) levels after statin monotherapy. Methods: Post hoc analysis was conducted of a prospective, open-label, single-cohort, multicenter Canadian study of 953 patients who were treated for 6 weeks with ezetimibe 10 mg/day coadministered with their current statin at an unaltered dose. For each patient, E-RCAD at baseline and at 6 weeks was calculated using the Framingham model. The primary outcome measure of the analysis was the change in E-RCAD. Results: A total of 825 patients with data at baseline and 6 weeks were included in the analysis. There were 423 (51.3%) patients with hypertension, 107 (13.0%) with diabetes mellitus but not metabolic syndrome, 160 (19.4%) with metabolic syndrome but not diabetes mellitus, and 235 (28.5%) with both diabetes mellitus and metabolic syndrome. After 6 weeks of ezetimibe coadministration with statin therapy, mean E-RCAD was reduced by 4.1% from 15.6% to 11.5%, which is equivalent to a 25.3% risk reduction (p < 0.001). Of the 225 (27.3%) patients with high E-RCAD (≥20.1%) at baseline, 144 (64.0%) converted to a lower E-RCAD category (p < 0.001). Patients with both diabetes mellitus and metabolic syndrome experienced the highest mean percent reduction in E-RCAD of –29.4% (p < 0.001). Conclusions: For patients with above-target LDL-C levels while on statin monotherapy, coadministration of ezetimibe with the statin is effective in significantly reducing the E-RCAD.

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RANTES gene mRNA expression and its −403 G/A promoter polymorphism in coronary artery disease

Gene ◽

10.1016/j.gene.2011.07.019 ◽

2011 ◽

Vol 487 (1) ◽

pp. 103-106 ◽

Cited By ~ 9

Author(s):

Javad Tavakkoly-Bazzaz ◽

Parvin Amiri ◽

Mohammad Tajmir-Riahi ◽

Daryoosh Javidi ◽

Maryam Khojasteh-Fard ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Mrna Expression ◽

Promoter Polymorphism ◽

Artery Disease ◽

Gene Mrna

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Potential benefits of ticagrelor plus aspirin in Chinese patients with stable coronary artery disease and diabetes

European Heart Journal ◽

10.1093/eurheartj/ehab724.1218 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

W Sun ◽

B Yan

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Absolute Risk ◽

Combined Therapy ◽

Stable Coronary Artery Disease ◽

Public Hospitals ◽

Chinese Patients ◽

Number Needed To Treat ◽

History Of ◽

Artery Disease

Abstract Purpose Ticagrelor plus aspirin has been shown to reduce the incidence of cardiovascular (CV) events compared to asprin alone in patients with stable coronary artery disease and diabetes in the THEMIS trial. This study aimed to estimate the potential CV benefit of adding ticagrelor to aspirin among a THMEIS-like Chinese population. Methods We retrospectively analyzed 13,322 patients with stable coronary artery disease and diabetes from 16 public hospitals in Hong Kong between August 2015 and July 2020. 5,642 (42.4%) patients who met inclusion and exclusion criteria of the THEMIS trial were included in final analysis. Estimated absolute risk reduction (eARR) in major adverse CV event (MACE, composite of myocardial infarction (MI), ischemic stroke or CV death) and number needed to treat (eNNT) were extrapolated based on results of the THEMIS trial. Results Of 5,642 THEMIS-like patients (62.1% male; mean age 69.6±10.4 years), 26.5% had history of percutaneous coronary intervention (PCI). During a median follow-up of 17.5 (IQR: 9.3–41.3) months, rates of MACE, MI, stroke and CV-death were 10.7% (n=605), 5.3% (n=298), 2.5% (n=139) and 5.5% (n=308), respectively. Kaplan-Meier estimates at 36 months stratified by history of PCI or not were 16.9% vs. 14.0% for MACE and 9.0% vs 6.7% for MI (both Log-rank p<0.01). Among THEMIS-like and THEMIS-PCI-like patients, eARR with ticagrelor plus aspirin was 1.4% (eNNT=71) and 1.6% (eNNT=63) for MACE and 1.5% (eNNT=67) and 1.9% (eNNT=53) for MI, respectively. Conclusion Approximately one third of Chinese patients with stable coronary artery disease and diabetes met THEMIS trial criteria. Combined therapy of ticagrelor and aspirin might provide similar clinical benefit in our population observed in the THEMIS trial, with low number needed to treat, especially in patients with previous PCI. FUNDunding Acknowledgement Type of funding sources: None.

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