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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Related Experiment Video

Updated: Sep 11, 2025

Assessing Endothelial Vasodilator Function with the Endo-PAT 2000
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Endothelial function in high-risk patients with ezetimibe therapy.

Merve Günes-Altan1, Agnes Bosch2, Kristina Striepe2

  • 1Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany (Drs Günes-Altan, Bosch, Striepe, Schiffer, Schmieder, and Kannenkeril); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany (Drs Günes-Altan and Achenbach).

Journal of Clinical Lipidology
|August 14, 2025
PubMed
Summary

Adding ezetimibe to statin therapy may improve endothelial function in high-risk atherosclerotic cardiovascular disease patients. This combination therapy showed better flow-mediated vasodilation and lower hsCRP levels compared to statin monotherapy.

Keywords:
Cardiovascular diseaseEndothelial functionEzetimibeFlow-mediated vasodilationStatins

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Pharmacology

Background:

  • Endothelial dysfunction is a predictor of cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD).
  • Optimized statin therapy is standard for high-risk patients, but further improvements in endothelial function may be beneficial.

Purpose of the Study:

  • To compare endothelial function in high-risk ASCVD patients receiving optimized statin therapy with or without the addition of ezetimibe.

Main Methods:

  • A post hoc analysis included 91 patients with ASCVD on statin therapy (atorvastatin or rosuvastatin).
  • Endothelial function was assessed using the UNEX EF device.
  • Patients were divided into two groups: those on statin plus ezetimibe (E+ group) and those on statin monotherapy (E- group).

Main Results:

  • The E+ group (n=21) exhibited significantly greater flow-mediated vasodilation (FMD) (6.1% vs 3.7%) and lower brachial intima-media thickness compared to the E- group (n=70).
  • Patients in the E+ group also had lower high-sensitivity C-reactive protein (hsCRP) levels (0.5 mg/L vs 1.1 mg/L).
  • These differences remained significant after adjusting for confounders, particularly for FMD and hsCRP.

Conclusions:

  • Ezetimibe combined with statin therapy may be associated with improved endothelial function in high-risk ASCVD patients compared to statin monotherapy.
  • The findings suggest a potential benefit of combination therapy on vascular health, though causal conclusions cannot be drawn from this cross-sectional analysis.