Influence of different lipid-lowering treatments on serum lipids,IL-6 and TNF-α in patients with coronary heart disease

Objective To compare the influence and safety of administration of atorvastatin(40 mg/d) and combination of atorvastatin(10 mg/d) with ezetimibe(10 mg/d) in the treatment of coronary heart disease,and evaluate the influence of interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-α).Methods 42 coronary heart disease patients(coronary artery stenosis between 50%-70% and no stent implantation) were classified to 2 groups: monotherapy group,40 mg atorvastatin(19 cases) and combined-therapy group,10 mg atorvastatin with 10 mg ezetimible(23 cases).These patients continued their open-label administration for 12 weeks.Blood samples were collected before treatment,4 weeks after treatment and 12 weeks after treatment.The total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),liver function,renal function,creatine kinase(CK),IL-6 and TNF-α were detected.Results Monotherapy reduced LDL-C by 37.82% [(1.94±0.49) mmol/L],and combined-therapy reduced LDL-C by 38.26% [(1.92±0.54) mmol/L] at 12 weeks.There was no obvious abnormality in liver function,renal function and CK after the treatment between the 2 groups.IL-6 and TNF-α levels significantly decreased in monotherapy after 12 weeks.However,there was no statistical difference in combined-therapy group before and after the treatment.Conclusions 10 mg/d ezetimibe coadministered with 10 mg/d atorvastatin in coronary heart disease patients has a lipid-lowering effect similar to 40 mg/d atorvastatin.Both had no abnormality in liver function,renal function and CK.Monotherapy may be superior to combined therapy in improving the levels of IL-6 and TNF-α.