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Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes.

Publication ,  Journal Article
Guyton, JR; Goldberg, RB; Mazzone, T; Weinstock, RS; Polis, A; Rosenberg, E; Tershakovec, AM
Published in: J Clin Lipidol
February 2008

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.

Duke Scholars

Published In

J Clin Lipidol

DOI

ISSN

1933-2874

Publication Date

February 2008

Volume

2

Issue

1

Start / End Page

19 / 24

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3205 Medical biochemistry and metabolomics
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 1101 Medical Biochemistry and Metabolomics
 

Citation

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Guyton, J. R., Goldberg, R. B., Mazzone, T., Weinstock, R. S., Polis, A., Rosenberg, E., & Tershakovec, A. M. (2008). Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes. J Clin Lipidol, 2(1), 19–24. https://doi.org/10.1016/j.jacl.2007.12.004
Guyton, John R., Ronald B. Goldberg, Theodore Mazzone, Ruth S. Weinstock, Adam Polis, Elizabeth Rosenberg, and Andrew M. Tershakovec. “Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes.J Clin Lipidol 2, no. 1 (February 2008): 19–24. https://doi.org/10.1016/j.jacl.2007.12.004.
Guyton JR, Goldberg RB, Mazzone T, Weinstock RS, Polis A, Rosenberg E, et al. Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes. J Clin Lipidol. 2008 Feb;2(1):19–24.
Guyton, John R., et al. “Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes.J Clin Lipidol, vol. 2, no. 1, Feb. 2008, pp. 19–24. Pubmed, doi:10.1016/j.jacl.2007.12.004.
Guyton JR, Goldberg RB, Mazzone T, Weinstock RS, Polis A, Rosenberg E, Tershakovec AM. Lipoprotein and apolipoprotein ratios in the VYTAL trial of ezetimibe/simvastatin compared with atorvastatin in type 2 diabetes. J Clin Lipidol. 2008 Feb;2(1):19–24.
Journal cover image

Published In

J Clin Lipidol

DOI

ISSN

1933-2874

Publication Date

February 2008

Volume

2

Issue

1

Start / End Page

19 / 24

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3205 Medical biochemistry and metabolomics
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 1101 Medical Biochemistry and Metabolomics