Effects of Combination of Ezetimibe and Rosuvastatin on Coronary Artery Plaque in Patients with Coronary Heart Disease

Heart Lung Circ. 2016 May;25(5):459-65. doi: 10.1016/j.hlc.2015.10.012. Epub 2015 Nov 18.


Background: In approximately 80% of cardiovascular disease-related deaths, patients suffer from coronary atherosclerotic heart disease. Ezetimibe is the first intestinal cholesterol absorption inhibitor. Its combination with statins for treating coronary atherosclerotic heart disease has attracted attention worldwide.

Methods: The study group comprised 106 patients with coronary atherosclerotic heart disease and hyperlipidaemia. Each was randomly assigned to one of two groups: (1) Ezetimibe (10mg, once a night) plus rosuvastatin (10mg, once a night) (n=55) or (2) Rosuvastatin alone (10mg, once a night) (n=51). The primary endpoint was new or recurrent myocardial infarction, unstable angina pectoris, cardiac death, and stroke. Blood lipid, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9) levels were measured before treatment and at one, six and 12 months after treatment. Coronary plaque size and compositional changes were determined using intravascular ultrasonography.

Results: The combination of ezetimibe plus rosuvastatin decreased total cholesterol, low-density lipoprotein cholesterol, hsCRP, IL-6, and MMP-9 levels at six and 12 months after treatment. Statistical significance was detected between two groups. At 12 months, the plaque burden, plaque cross-sectional area, and percentage of necrotic plaque composition were significantly lower in the combination group than in rosuvastatin alone group (P<0.05). And compared with rosuvastatin alone group, the primary endpoint decreased more effectively in combination group.

Conclusions: The combination of ezetimibe and rosuvastatin apparently diminishes lipid levels and plaque burden and improves plaque stability, which may be associated with the potent inhibitory effects of ezetimibe and rosuvastatin on inflammatory cytokines.

Keywords: Coronary artery plaque; Ezetimibe; High-sensitivity C-reactive protein; Interleukin-6; Matrix metalloproteinase-9; Rosuvastatin.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism
  • Coronary Artery Disease* / blood
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / drug therapy
  • Drug Therapy, Combination
  • Ezetimibe / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Interleukin-6 / blood
  • Male
  • Matrix Metalloproteinase 9 / blood
  • Middle Aged
  • Plaque, Atherosclerotic* / blood
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / drug therapy
  • Rosuvastatin Calcium / administration & dosage*
  • Ultrasonography, Interventional*


  • IL6 protein, human
  • Interleukin-6
  • Rosuvastatin Calcium
  • C-Reactive Protein
  • MMP9 protein, human
  • Matrix Metalloproteinase 9
  • Ezetimibe