Age, abdominal obesity, and baseline high-sensitivity C-reactive protein are associated with low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B responses to ezetimibe/simvastatin and atorvastatin in patients with metabolic syndrome

Jennifer G Robinson; Christie M Ballantyne; Willa A Hsueh; Jeffrey B Rosen; Jianxin Lin; Arvind K Shah; Joanne E Tomassini; Robert S Lowe; Andrew M Tershakovec

doi:10.1016/j.jacl.2013.03.007

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Age, abdominal obesity, and baseline high-sensitivity C-reactive protein are associated with low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B responses to ezetimibe/simvastatin and atorvastatin in patients with metabolic syndrome

Journal article

Peer reviewed

Age, abdominal obesity, and baseline high-sensitivity C-reactive protein are associated with low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B responses to ezetimibe/simvastatin and atorvastatin in patients with metabolic syndrome

Jennifer G Robinson, Christie M Ballantyne, Willa A Hsueh, Jeffrey B Rosen, Jianxin Lin, Arvind K Shah, Joanne E Tomassini, Robert S Lowe and Andrew M Tershakovec

Journal of clinical lipidology, Vol.7(4), pp.292-303

07/2013

DOI: 10.1016/j.jacl.2013.03.007

PMID: 23890516

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Abstract

Treatment response to lipid-lowering therapy can vary in patients with the metabolic syndrome (MetS) due to various patient demographic and baseline characteristics. This study assessed the relationships between baseline characteristics and changes in lipid variables, high-sensitivity C-reactive protein (hs-CRP) and attainment of prespecified low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels in MetS patients treated with ezetimibe/simvastatin and atorvastatin. This is a post-hoc analysis of a multicenter, double-blind, randomized, 6-week parallel study in >1000 hypercholesterolemic subjects (median age of 59 years) with MetS and moderately high/high coronary heart disease risk who were treated with ezetimibe/simvastatin (10/20 and 10/40 mg) or atorvastatin (10, 20, 40 mg). Factors that could affect these treatments were assessed by multivariate analysis. Increasing age, abdominal obesity (waist circumference ≥40/35 inches for men/women), and lower baseline hs-CRP were significant predictors of greater reductions in LDL-C, non-HDL-C, apolipoprotein B, total cholesterol, triglycerides, and very-low-density lipoprotein cholesterol but not for changes in HDL-C or apolipoprotein AI; effects of race and baseline triglycerides, non-HDL-C, LDL-C, or HDL-C levels were more limited. Age ≥65 years (versus <65 years) was also associated with significantly greater attainment of all LDL-C and non-HDL-C targets, whereas abdominal obesity, gender (female > male) and lower baseline LDL-C, non-HDL-C, triglycerides, and hs-CRP were associated with improved attainment for some of these targets. Blood pressure, fasting glucose, Homeostasis Model Assessment of Insulin Resistance tertiles, and diabetes did not predict response for any efficacy variable. Ezetimibe/simvastatin treatment (versus atorvastatin) was a significant predictor for change in most efficacy variables. Treatment responses to ezetimibe/simvastatin and atorvastatin in at-risk patients with the MetS were related to age (≥65 years), abdominal obesity, and lower baseline hs-CRP. Ezetimibe/simvastatin treatment was found to be consistently more effective than atorvastatin at the specified dose comparisons across these subgroups. The clinical value of predictive factors requires further study in outcome trials.

Abdominal obesity

LDL-C

Atorvastatin

Metabolic syndrome

Multivariate analysis

Non-HDL-C

Ezetimibe/simvastatin

Age

Details

Title: Subtitle: Age, abdominal obesity, and baseline high-sensitivity C-reactive protein are associated with low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B responses to ezetimibe/simvastatin and atorvastatin in patients with metabolic syndrome
Creators: Jennifer G Robinson - Departments of Epidemiology & Medicine, Co-Director, Prevention Intervention Center, College of Public Health, University of Iowa College of Public Health, 105 River Street, S455 CPBH, Iowa City, IA 52242, USA
Christie M Ballantyne - Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
Willa A Hsueh - Methodist Hospital Research Institute, Houston, TX, USA
Jeffrey B Rosen - Clinical Research of South Florida, Coral Gables, FL, USA
Jianxin Lin - Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
Arvind K Shah - Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
Joanne E Tomassini - Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
Robert S Lowe - Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
Andrew M Tershakovec - Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
Resource Type: Journal article
Publication Details: Journal of clinical lipidology, Vol.7(4), pp.292-303
Publisher: Elsevier Inc
DOI: 10.1016/j.jacl.2013.03.007
PMID: 23890516
ISSN: 1933-2874
eISSN: 1876-4789
Language: English
Date published: 07/2013
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983995031202771

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