Abstract

Background: Microwave radiometry (MWR) assesses non-invasive carotid artery temperatures reflecting inflammation. In the present study, we aimed to investigate the impact of hypolipidemic therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures of patients with familial hyperlipidemia syndromes (FHS). Methods: Consecutive patients with diagnosis of either familial heterozygous hypercholesterolemia (heFH) or familial combined hyperlipidemia (FCH) were included in the study. Patients were assigned to either simvastatin 40 mg or simvastatin 40 mg plus ezetimibe 10 mg, according to the discretion of the physician. FHS patients who refused statin therapy were used as a control group. Common carotid intima-media thickness (ccIMT) was measured and ΔΤ (maximum-minimum) temperature measurements were performed across each carotid during MWR evaluation. RESULTS: In total, 115 patients were included in the study. Of them, 40 patients received simvastatin (19 heFH and 21 FCH), 41 simvastatin + ezetimibe (31 heFH and 10 FCH), and 34 (21 heFH and 13 FCH) no statin. Carotid artery temperatures were significantly reduced at 6 months in FH patients who received hypolipidemic treatment (0.83 ± 0.34 versus 0.63 ± 0.24 °C, p = 0.004 for simvastatin, 1.00 ± 0.38 versus 0.69 ± 0.23 °C, p < 0.001 for simvastatin + ezetimibe), but no change was recorded in controls (0.72 ± 0.26 versus 0.70 ± 0.26 °C, p = 0.86). Conclusions: Hypolipidemic therapy reduced carotid temperatures in FHS patients.

Highlights

  • Statin therapy constitutes the main choice for the management of patients with familial hyperlipidemia syndromes

  • We aimed to evaluate whether (1) the initiation of statin therapy in patients with familial hyperlipidemia syndromes has an effect on carotid temperatures and (1) the addition of ezetimibe on top of simvastatin reduces incrementally carotid inflammation as estimated by measuring carotid temperatures

  • 115 patients with familial hyperlipidemia syndromes were included in the study

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Summary

Introduction

Statin therapy constitutes the main choice for the management of patients with familial hyperlipidemia syndromes. Both heterozygous familial hypercholesterolemia (heFH) and familial combined hyperlipidemia (FCH) patients exhibit higher systemic as well as vascular inflammation, compared to controls [2], and maintained an inflammatory phenotype despite long-term therapy with statins [3]. We aimed to investigate the impact of hypolipidemic therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures of patients with familial hyperlipidemia syndromes (FHS). Carotid artery temperatures were significantly reduced at 6 months in FH patients who received hypolipidemic treatment (0.83 ± 0.34 versus 0.63 ± 0.24 ◦C, p = 0.004 for simvastatin, 1.00 ± 0.38 versus 0.69 ± 0.23 ◦C, p < 0.001 for simvastatin + ezetimibe), but no change was recorded in controls (0.72 ± 0.26 versus 0.70 ± 0.26 ◦C, p = 0.86).

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