The effect of dual inhibition of cholesterol in hyperlipidemia patients with acute myocardial infarction / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: A moderate dose of statin/ezetimbe combination therapy reduced the LDL-C (low density lipoprotein-cholesterol) in a fashion comparable to high dose statin without increasing the adverse events in patients with primary hypercholesterolemia. Yet there is no data on the effectiveness and safety of statin/ezetimbe combination therapy in patients suffering with acute myocardial infarction (AMI). METHODS: We retrospectively compared the lipid profiles and clinical variables of 82 patients who were admitted to our institution with AMI. These patients were successfully treated with emergent coronary intervention within 12 hours after the chest pain onset and they were prescribed a single statin (statin group) or statin/ezetimibe combination therapy (dual inhibition group) for treating their hyperlipidemia within 72 hours after the admission. We compared the initial lipid profiles, the % reduction of total cholesterol (TC), the LDL-C at 1 and 6 months and the safety profiles between the two therapeutic groups. RESULTS: Although the initial TC and LDL-C levels were significantly higher in the dual inhibition group than the statin group, one month later, the % reduction of the TC was 27.9+/-13.1% and 17.0+/-15.0% (p=0.004) and the % reduction of the LDL-C was 38.5+/-12.5% and 25.1+/-18.9% (p=0.001) in each group, respectively. One patient in the dual inhibition group showed CPK elevation more than 3 times the upper normal limit and ALT elevation more than 2 times of upper normal limit was observed in one patient in the statin group. CONCLUSIONS: Cholesterol dual inhibition therapy is superior to single statin therapy for the aspect of cholesterol reduction and safety in successfully reperfused AMI patients.