ECE2018 Poster Presentations: Diabetes, Obesity and Metabolism Cardiovascular Endocrinology and Lipid Metabolism (25 abstracts)
Effects of atorvastatin and ezetimibe therapy on LDL Cholesterol. A systematic review and meta-analysis of randomized controlled trial
Richard Buendia 1, , Monica Zambrano 3, , Andres Buendia 5 , Tatiana Vargas 6 , Alejandra Morales 6 , Adriana Alejo 7 , Santiago Cardenas 8 , Heidy Mier 9 , Diego Sanchez 10 & Johann Arrautt 11
1Colsubsidio Centro De Especialistas, Bogota D.C, Colombia; 2Hospital De La Policia, Bogota D.C, Colombia; 3Hospital De La Samaritana, Bogota D.C, Colombia; 4Colsubsidio, Bogota D.C, Colombia; 5Fundación Universitaria de Ciencias de la Salud: Fucs, Bogota D.C, Colombia; 6Universidad De La Sabana, Bogota D.C, Colombia; 7Universidad El Rosario, Bogota D.C, Colombia; 8Pontificia Universidad Javeriana, Bogota D.C, Colombia; 9Universidad De Santander, Bogota D.C, Comoros; 10Universidad El Bosque, Bogota D.C, Colombia; 11Universidad Del Magdalena, Bogota D.C, Colombia.
Background: Evidence has shown that the use of high doses of statins is associated with lower levels of LDL cholesterol and a decrease in cardiovascular events. Likewise, the use of high doses of statins may increase the risk of myopathy, elevation of liver enzymes, renal failure and cognitive alterations. We conducted a systematic review with a meta-analysis of all RCTs investigating the impact of atorvastatin and ezetimibe therapy on levels of LDL cholesterol vs high doses of atorvastin.
Methods: We comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane from their dates of inception through October 2017. The inclusion criteria were published RCTs comparing change in LDL cholesterol between Atorvastatin/Ezetimibe (10/10 mg and 20/10 mg) administration and Atorvastatin in high doses (40 and 80 mg/day). We used a random-effects model and calculated pooled standardized mean difference (SMD) with 95% confidence intervals (CI) comparing change in levels of LDL cholesterol (mg/dl) between the atorvastatin/ezetimibe and atorvastatin in high doses groups.
Results: Three studies were included in the meta-analysis. Atorvastain/ezetimibe 10/10 mg and 20/10 mg compared with atorvastian in high doses (40 and 80 mg) group; the atorvastatin/ezetimibe therapy group had lower cholesterol LDL (SMD=−14.00 mg/dl, 95% CI: −14.23 to −13.83, P-value heterogeneity=0.60, I2=0%). The rank correlation test of funnel plot asymmetry was z=1.56, P-value=0,11.
Conclusion: This meta-analysis of randomized studies demonstrates how atorvastatin/ezetimibe at low doses such as 10/10 mg and 20/10 mg vs atorvastatin 40 mg and 80 mg, was superior in reducing LDL cholesterol levels by 14 mg/dl, statistically significantly, and without publication bias (determined by the test of funnel plot asymmetry).
Volume 56
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Endocrine Abstracts
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