Comparison of High-Dose Rosuvastatin Versus Low-Dose Rosuvastatin Plus Ezetimibe on Carotid Atherosclerotic Plaque Inflammation in Patients with Acute Coronary Syndrome

Minyoung Oh; Hyunji Kim; Eon Woo Shin; Changhwan Sung; Do-Hoon Kim; Dae Hyuk Moon; Nayoung Kim; Jae Seon Eo; Jin Won Kim; Cheol Whan Lee

doi:10.1007/s12265-020-10009-4

Comparison of High-Dose Rosuvastatin Versus Low-Dose Rosuvastatin Plus Ezetimibe on Carotid Atherosclerotic Plaque Inflammation in Patients with Acute Coronary Syndrome

J Cardiovasc Transl Res. 2020 Dec;13(6):900-907. doi: 10.1007/s12265-020-10009-4. Epub 2020 May 4.

Authors

Minyoung Oh¹, Hyunji Kim¹, Eon Woo Shin¹, Changhwan Sung¹, Do-Hoon Kim¹, Dae Hyuk Moon¹, Nayoung Kim², Jae Seon Eo³, Jin Won Kim⁴, Cheol Whan Lee^{5

6}

Affiliations

¹ Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
² Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
³ Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, South Korea.
⁴ Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea.
⁵ Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. [email protected].
⁶ Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. [email protected].

PMID: 32367340
DOI: 10.1007/s12265-020-10009-4

Abstract

We compared the effects of ezetimibe/rosuvastatin 10/5 mg versus rosuvastatin 20 mg on carotid atherosclerotic plaque inflammation measured by ¹⁸FDG PET/CT. Fifty patients with acute coronary syndrome (ACS) were randomly assigned to the ezetimibe/rosuvastatin 10/5 mg and rosuvastatin 20 mg groups. The primary outcome was the percent change in the target-to-background ratio (TBR) of the index vessel in the most diseased segment (MDS), as assessed by ¹⁸FDG PET/CT at baseline and at 6 months. Forty-eight patients completed follow-up PET/CT. MDS TBR was - 6.2 ± 13.9% for patients in the ezetimibe/rosuvastatin group and - 10.8 ± 17.7% for those in the rosuvastatin group (difference, 4.6 percentage points; upper limitation of one-sided confidence interval = 13.8; p = 0.60 for noninferiority). In conclusion, combination therapy with ezetimibe 10 mg and rosuvastatin 5 mg compared with rosuvastatin 20 mg did not meet the criterion for non-inferiority for primary outcome, and the present study was not conclusive on whether the former was non-inferior to the latter. Graphical Abstract.

Keywords: Ezetimibe; Plaque inflammation; Positron emission tomography; Statin.

Publication types

Comparative Study
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Acute Coronary Syndrome / diagnostic imaging
Acute Coronary Syndrome / drug therapy*
Aged
Anti-Inflammatory Agents / administration & dosage*
Anti-Inflammatory Agents / adverse effects
Anticholesteremic Agents / administration & dosage*
Anticholesteremic Agents / adverse effects
Carotid Artery Diseases / diagnostic imaging
Carotid Artery Diseases / drug therapy*
Drug Combinations
Ezetimibe / administration & dosage*
Ezetimibe / adverse effects
Female
Fluorodeoxyglucose F18 / administration & dosage
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
Male
Middle Aged
Plaque, Atherosclerotic*
Positron Emission Tomography Computed Tomography
Prospective Studies
Radiopharmaceuticals / administration & dosage
Rosuvastatin Calcium / administration & dosage*
Rosuvastatin Calcium / adverse effects
Seoul
Time Factors
Treatment Outcome

Substances

Anti-Inflammatory Agents
Anticholesteremic Agents
Drug Combinations
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Radiopharmaceuticals
Fluorodeoxyglucose F18
Rosuvastatin Calcium
Ezetimibe