Effects of Statin and Ezetimibe Association on Kinetics of Artificial Chilomicrons
Effects of statin and ezetimibe association on kinetics of artificial chylomicrons in men with stable coronary heart disease (CHD).
The rate (kinetics) of chylomicrons removal from circulation have been correlated with the incidence and severity of atherosclerotic lesions; a number of studies demonstrated lower plasmatic clearance of chylomicrons in patients with CHD compared to patients without this condition. It was also demonstrated a correlation among LDL-C levels and removal of chylomicrons remnants by a technique employing artificial chylomicrons.
The investigators also know that higher doses of more potent statins are more effective in chylomicrons removal than lower doses or less potent statins; nevertheless, the effect of the isolated use of statin has not been completely studied up to now.
The investigators propose to study 26 outpatients volunteers with chronic CHD, followed at the Heart Institute - INCOR - of the School of Medicine, University of São Paulo.
Following a period of six weeks of washout from any cholesterol reducer, the kinetics of chylomicrons removal by a technique of emulsion of radiolabeled artificial chylomicrons will be evaluated. Lipid fractions, hepatic enzymes and CK will be measured. Initially patients will be randomly allocated to receive simvastatin 20 mg /day (n= 13) or ezetimibe 10 mg/day (n=13) for six weeks. At the end of this period, kinetics of chylomicrons removal and laboratorial measurements will be repeated (Period 1).
In the next period (Period 2) patients will receive simvastatin 20 mg/ ezetimibe 10 mg (n=13) or simvastatin 80 mg (n=13) for additional six weeks; at the end of this period, the evaluations will be repeated (third and last evaluation).
The aim of this study is to further understand chylomicrons metabolism in patients with chronic coronary disease receiving cholesterol reducers at different dosage regimes.
|Coronary Heart Disease||Drug: Simvastatin 20mg plus ezetimibe 10mg Drug: ezetimibe Drug: simvastatin 20mg Drug: Simvastatin 80mg||Phase 4|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Effects of Statin and Ezetimibe Association on Kinetics of Artificial Chilomicrons in Men With Stable Coronary Heart Disease.|
- Cholesteryl Ester Fractional Clearance Rate [ Time Frame: 6 weeks ]
- Low Density Lipoprotein [ Time Frame: 12week ]
- Triglyceride Fractional Clearance Rate [ Time Frame: 6week ]
- Alanine Aminotransferase [ Time Frame: 12 weeks ]
- CPK [ Time Frame: 12 week ]
- Total Cholesterol [ Time Frame: 12 week ]
- High Density Lipoprotein [ Time Frame: 12 week ]
|Study Start Date:||June 2007|
|Study Completion Date:||January 2010|
|Primary Completion Date:||January 2010 (Final data collection date for primary outcome measure)|
Experimental: group1 ezetimibe
6 week wash out, followed by 06 week ezetimibe 10mg once a day e then 6 week ezetimibe 10mg plus sinvastatin 20mg for more 6 week.
Drug: Simvastatin 20mg plus ezetimibe 10mg
simvastatin 20mg plus ezetimibe 10mg once a day for 6 week.Drug: ezetimibe
ezetimiba 10mg once a day
Active Comparator: group 2 simvastatin
6 week simvastatin 20mg once a day followed by 6 week simvastatin 80mg once a day.
Drug: simvastatin 20mg
simvastatin 20mg once a dayDrug: Simvastatin 80mg
simvastatin 20mg for 6week and then simvastatin 80mg for the next 6week.
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00481351
|Study Director:||Raul D. Santos, Physician||University of Sao Paulo|
|Principal Investigator:||Otavio C. Mangili, Physician||University of Sao Paulo|
|Study Chair:||Raul C Maranhão, physician||University of Sao Paulo|
|Study Chair:||Ana Carolina M Gagliardi, nutritionist||University of Sao Paulo|