The efficacy of ezetimibe on treating coronary heart dis-ease complicated with hyperlipidemia and effects on lipid metabolism and atherosclerosis improvement

ZHENG Yu-qi; LUO Xiao-qin

doi:10.3969/j.issn.1009-8933.2025.03.001

Abstract：Background In recent years, the incidence of coronary heart disease (CHD) has continued to rise, and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients. Statin monotherapy faces limitations in efficacy for some patients and raises potential safety concerns. Ezetimibe, as a novel lipid-modulating agent, exhibits potential advantages in the treatment of hyperlipidemia. Based on this, the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia, as well as its effects on lipid metabolism and the amelioration of atherosclerosis. Methods In this study, 150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis. According to different treatment methods, they were randomly divided into the Atorvastatin group (control group, n=75) and the Atorvastatin + Ezetimibe group (experimental group, n=75). Control group received atorvastatin monotherapy, while experimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen. The clinical efficacy of the two treatment groups was analyzed, including cardiac function-related parameters such as the cardiac index (CI), cardiac output (CO), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) before and after treatment. The observed indicators encompassed coronary angiography findings, the Gensini score for assessing coronary stenosis severity, the inflammatory marker high-sensitivity C-reactive protein (hs-CRP), and lipid profile parameters including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Additionally, the occurrence of adverse reactions during treatment was monitored. Results After treatment, the total effective rate in experimental group was significantly higher than that in control group, with a statistically significant difference (P<0.05). In the comparison of the baseline data, both groups showed marked improvements in CI, CO, LVEF, and HDL-C. However, at the same time points, the experimental group demonstrated significantly better results in these parameters than control group (P<0.05). Additionally, LVEDD, LDL-C, hs-CRP and Gensini scores were significantly reduced after treatment in both groups compared to pretreatment levels. Moreover, at identical time points, the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group (P<0.05). Regarding safety assessment, comparative analysis of adverse drug reaction (ADR) incidence rates between the two treatment groups revealed no statistically significant difference (P>0.05). Conclusions In patients with CHD complicated by hyperlipidemia, ezetimibe demonstrates significant therapeutic advantages. It effectively enhances treatment efficacy, regulates lipid profiles, improves cardiac function, and mitigates the progression of atherosclerosis. This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.