Treatment With Ezetimibe Plus Low-Dose Atorvastatin Compared With Higher-Dose Atorvastatin AloneIs Sufficient Cholesterol-Lowering Enough to Inhibit Platelets?
Michael Piorkowski, MD*,
Sabine Fischer, MD*,
Caroline Stellbaum, MD*,
Markus Jaster, MD*,
Peter Martus, PhD ,
Andreas J. Morguet, MD*,
Heinz-Peter Schultheiss, MD* and
Ursula Rauch, MD*,*
* Department of Internal Medicine/Cardiology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
Institute for Biostatistics and Clinical Epidemiology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.
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Figure 1 Differences in Low-Density Lipoprotein Cholesterol Levels ( LDL-C)
Levels at 4 weeks after lipid-lowering therapy compared with levels before changing treatment. Atorvastatin 40 mg/day (open bars, n = 25) and ezetimibe 10 mg/day plus atorvastatin 10 mg/day (solid bars, n = 26).
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Figure 2 Differences in ADP-Induced P-Selectin Expression on Platelets
(A) Platelet P-selectin expression after adenosine diphosphate (ADP) stimulation at baseline and after 4 weeks of lipid-lowering therapy with atorvastatin (open bars, n = 25) or a combination of ezetimibe plus atorvastatin (solid bars, n = 26). (B) Differences in median immunofluorescence intensity (MFI) in P-selectin expression (level after 4 weeks of lipid-lowering therapy minus level before changing treatment). AU = arbitrary units.
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Figure 3 Differences in TRAP-Induced P-Selectin Expression on Platelets
(A) Platelet P-selectin expression after stimulation with thrombin receptor-activating peptide (TRAP) at baseline and after 4 weeks of lipid-lowering therapy with atorvastatin (open bars, n = 25) or a combination of ezetimibe plus atorvastatin (solid bars, n = 26). (B) Differences in median immunofluorescence intensity in P-selectin expression (level after 4 weeks of lipid-lowering therapy minus level before changing treatment). Abbreviations as in Figure 2.
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Figure 4 RANTES Levels in Blood Pre- and Post–Lipid-Lowering Therapy
(A) Plasma regulated on activation normally T-cell expressed and secreted (RANTES) concentration at baseline and after 4 weeks of lipid-lowering therapy with atorvastatin (open bars, n = 25) or a combination of ezetimibe plus atorvastatin (solid bars, n = 26). (B) Differences (c) in plasma RANTES concentration (level after 4 weeks of lipid-lowering therapy minus level before changing treatment). c = concentration.
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