Variability in Plasma Lipids between Intensive Statins Therapy and Conventional-dose Statins Combined with Ezetimibe Therapy in Patients with Coronary Atherosclerosis Disease

Abstract Background: Dyslipidemia is one of the risks of coronary atherosclerosis disease (CAD). Intensive-dose statins or combining with ezetimibe are widely used to improve the lipid-lowering efficacy in the clinic. Recently, lipid variability has gradually gained attention to be a more reliable predictor of cardiovascular events. We aimed to investigate the variability in plasma lipids in the above two lipid-lowering strategy.Methods: It was a multicenter retrospective study, a total of 1275 patients with CAD from January 2009 to April 2019 were divided into 2 groups: intensive statins (atorvastatin 40 mg/d or rosuvastatin 20 mg/d) group and conventional-dose statins (atorvastatin 20 mg/d or rosuvastatin 10 mg/d) combined with ezetimibe group. All patients were followed up for at least 1-year. Multiple linear regression was used to analyze the association of two lipid-lowering regimens with plasma lipids variability; and subgroup analyses of the relevant factors were applied. All verifications are verified by standard deviation (SD), coefficient of variation (CV), and variability independent of mean (VIM) triple methods.Results: In the overall participants, the mean age was 62.3±10.4 years old, and 72.8% was male. Multivariate linear regression indicated that intensive statins group had lower variability in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) in all SD, CV, and VIM triple methods than statins combined with ezetimibe group (p for all <0.05). The similar results were established in the subgroup analyses based on atorvastatin or rosuvastatin, diabetes mellites or not, hypertension or not (p for all <0.05).Conclusions: Intensive statins therapy has lower variability in TC, LDL-C, and non-HDL-C, that is, better lipids stability than statins combined with ezetimibe therapy in patients with CAD.