Ezetimibe potential in cardiology practice

Vascular wall infiltration with lipoproteins, in particular with low-density lipoprotein (LDL) cholesterol (LDLCH), plays an important role in atherosclerosis pathogenesis. Elevated LDL-CH levels are associated with increased risk of coronary heart disease (CHD). Based on the evidence from experimental and clinical studies, there is a direct link between LDL-CH reduction and decreased incidence of cardiovascular events. Statins are medications of choice for LDL-CH reduction; however, statin monotherapy does not always result in target LDLCH level achievement, due to pharmaco-genetic factors and adverse effects of the therapeutically effective statin doses. In these clinical situations, a combination of low-dose statins with other lipid-lowering agents is effective. Recently, high effectiveness of statin combination with ezetimibe (inhibitor of intestine CH absorption) has been demonstrated. It is explained by targeting both mechanisms which determine blood CH levels (intestine absorption and hepatic synthesis), with a substantial reduction in LDL-CH levels as a result.