PMID- 21291711
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20110204
IS  - 1933-2874 (Print)
IS  - 1876-4789 (Linking)
VI  - 2
IP  - 1
DP  - 2008 Feb
TI  - Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin 
      compared with atorvastatin in type 2 diabetes.
PG  - 19-24
LID - 10.1016/j.jacl.2007.12.004 [doi]
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with a high risk for 
      coronary heart disease (CHD). A variety of lipoprotein and apolipoprotein (Apo) 
      ratios have been proposed that may reflect the balance of cholesterol delivery 
      and removal at the arterial wall and provide an assessment of CHD risk that is 
      supplemental to low-density lipoprotein cholesterol (LDL-C), the primary guide 
      for cholesterol-lowering therapy in patients at risk. OBJECTIVE: To examine 
      changes in lipoprotein and apolipoprotein ratios in the VYTAL trial of 
      hypercholesterolemic patients with T2DM. METHODS: Changes in the ratios 
      LDL-C/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/HDL-C, 
      non-HDL-C/HDL-C, and ApoB/ApoA-I were assessed in this randomized, double-blind, 
      parallel-group study that enrolled T2DM patients with LDL-C >/=100 mg/dL for 6-week 
      treatments with either the usual daily starting doses of atorvastatin (ATORVA) 10 
      or 20 mg or ezetimibe/simvastatin (EZE/SIMVA) 10/20 mg, or the next highest doses 
      (ATORVA 40 mg, EZE/SIMVA 10/40 mg). Changes in lipoprotein and apolipoprotein 
      ratios, prespecified exploratory endpoints, were analyzed using analysis of 
      variance. RESULTS: Efficacy results were based on 1198 patients with sufficient 
      data among 1229 randomized patients. Baseline lipoproteins, apolipoproteins, and 
      ratios were comparable among treatment groups. EZE/SIMVA produced significantly 
      greater reductions compared with ATORVA in each lipoprotein or apolipoprotein 
      ratio at each dose comparison (P < 0.001). For example, reductions from baseline 
      in TC/HDL-C were ATORVA 10 mg, -30.2%; ATORVA 20 mg -34.9%; EZE/SIMVA 10/20 mg, 
      -41.6%; ATORVA 40 mg, -37.9%; and EZE/SIMVA 10/40 mg, -43.5%. Tolerability of the 
      two treatments was similar. CONCLUSION: For the doses assessed, EZE/SIMVA was 
      more effective compared with ATORVA in lowering the lipoprotein and 
      apolipoprotein ratios that might be considered secondary measures of CHD risk.
FAU - Guyton, John R
AU  - Guyton JR
AD  - Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Box 
      3510, Duke University, Durham, NC 27710, USA.
FAU - Goldberg, Ronald B
AU  - Goldberg RB
FAU - Mazzone, Theodore
AU  - Mazzone T
FAU - Weinstock, Ruth S
AU  - Weinstock RS
FAU - Polis, Adam
AU  - Polis A
FAU - Rosenberg, Elizabeth
AU  - Rosenberg E
FAU - Tershakovec, Andrew M
AU  - Tershakovec AM
LA  - eng
PT  - Journal Article
DEP - 20080106
PL  - United States
TA  - J Clin Lipidol
JT  - Journal of clinical lipidology
JID - 101300157
EDAT- 2008/02/01 00:00
MHDA- 2008/02/01 00:01
CRDT- 2011/02/05 06:00
PHST- 2007/10/17 00:00 [received]
PHST- 2007/12/21 00:00 [revised]
PHST- 2007/12/25 00:00 [accepted]
PHST- 2011/02/05 06:00 [entrez]
PHST- 2008/02/01 00:00 [pubmed]
PHST- 2008/02/01 00:01 [medline]
AID - S1933-2874(08)00002-0 [pii]
AID - 10.1016/j.jacl.2007.12.004 [doi]
PST - ppublish
SO  - J Clin Lipidol. 2008 Feb;2(1):19-24. doi: 10.1016/j.jacl.2007.12.004. Epub 2008 
      Jan 6.