Switching from statin monotherapy to ezetimibe/simvastatin or rosuvastatin modifies the relationships between apolipoprotein B, LDL cholesterol, and non-HDL cholesterol in patients at high risk of coronary disease.

Author(s): Vaverkova H, Farnier M, Averna M, Missault L, Viigimaa M, Dong Q, Shah A, Johnson-Levonas AO, Brudi P

Affiliation(s): 3rd Department of Internal Medicine, Medical Faculty, University Hospital Olomouc, Olomouc, Czech Republic. Helena.Vaverkova@fnol.cz

Publication date & source: 2011-06, Clin Biochem., 44(8-9):627-34. Epub 2011 Feb 22.

Publication type: Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: To evaluate relationships between apolipoprotein B (Apo B), LDL cholesterol (LDL-C), and non-HDL-C in high-risk patients treated with lipid-lowering therapy. DESIGN AND METHODS: This post-hoc analysis calculated LDL-C and non-HDL-C levels corresponding to an Apo B of 0.9 g/L following treatment with 1) statin monotherapy (baseline) and 2) ezetimibe/simvastatin 10/20mg or rosuvastatin 10mg (study end). The percentages of patients reaching LDL-C, non-HDL-C, and Apo B targets were calculated at study end. RESULTS: After switching to ezetimibe/simvastatin or rosuvastatin, the LDL-C and non-HDL-C corresponding to Apo B=0.9 g/L were closer to the more aggressive LDL-C and non-HDL-C goals (1.81 and 2.59 mmol/L, respectively). Only slightly >50% of the patients who reached minimum recommended LDL-C or non-HDL-C at study end also had an Apo B level <0.9 g/L with both treatments. CONCLUSION: The use of Apo B for monitoring the efficacy of lipid-altering therapy would likely lead to more stringent criteria for lipid lowering. Copyright (c) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.