Endothelial function in high-risk patients with ezetimibe therapy

Background Impaired endothelial function predicts cardiovascular (CV) events, especially in patients with established CV disease. The aim of this post hoc analysis was to compare the endothelial function between high-risk patients on optimized statin therapy with and without additional ezetimibe treatment. Methods A total of 91 patients with CV and statin treatment (Atorvastatin or Rosuvastatin) were included and underwent examination of endothelial function by the UNEX EF device. Endothelial function parameters were compared between patients with (E + group) and without ezetimibe therapy (E- group) (NCT03626831). Results Compared to patients in the E- group (n = 70), patients in the E + group (n = 21) were younger (67.0 ± 7.4 versus 61.2 ± 7.2 years; p = 0.002), had lower low density lipoprotein cholesterol (91.2 ± 13.3 versus 102.0 ± 18.1 mg/dl (p = 0.013) and lower office systolic blood pressure (123.9 ± 11.4 versus 130.2 ± 14.5 mmHg (p = 0.042). High sensitive C-reactive protein (hsCRP) was lower in the E + group than in the E- group (0.5 ± 0.4 versus 1.1 ± 0.9 mg/L; p = 0.037). We found a greater flow-mediated vasodilation (6.1 ± 2.0 versus 3.7 ± 3.2%; p = 0.004) and lower brachial intima-media thickness (0.28 ± 0.1 versus 0.32 ± 0.0 mm; p = 0.011) in the E + group compared to the E- group. When confounders were entered in a covariance analysis, differences of FMD (p = 0.034) and hsCRP (p = 0.049) between the groups remained significant. Conclusion Our data indicate that endothelial function is better in high-risk patients with preexisting CV disease treated with ezetimibe along with statin than in patients with statin monotherapy. Trial registration Number: NCT03626831 Date of registration: 2018-08-08