Effect of ezetimibe combined with metoprolol on cardiac function,lipid metabolism and vascular endothelial function in elderly patients with coronary atherosclerotic heart disease and heart failure
Wu Xiao-hua
Wang Xing-xing
Hu Xue-ling
Abstract：Objective To explore the application of ezetimibe combined with metoprolol in elderly patients with coro-nary heart disease (CHD) complicated with heart failure and the influence on lipid metabolism and vascular endothelial function. Methods A total of 82 elderly patients with CHD admitted to Zhoushan Hospital from January 2021 to December 2023 were included and divided into metoprolol group and ezetimibe group according to the difference of medications. Both groups re-ceived conventional treatment,and the metoprolol group was given metoprolol tartrate tablet,whereas the ezetimibe group was supplemented with ezetimibe tablet on the basis of the metoprolol group. Both groups were treated for 6 months. The two groups were matched at 1:1 by the propensity matching scoring method to exclude the influence of confounding factors of baseline data,and finally 41 cases were included in each group. The clinical efficacy,and cardiac function,lipid metabolism,carotid ar-tery plaque and vascular endothelial function before and after treatment were compared. Major adverse cardiovascular events (MACE) and adverse drug reactions were counted in the two groups within 6 months of treatment. Results There was no sta-tistical significance in the total effective rate of clinical efficacy between ezetimibe group (97.56％,40/41) and metoprolol group (85.36％,35/41) (x2=2.499,P=0.114). After 6 months of treatment,the left ventricular ejection fraction (LVEF),high density lipoprotein cholesterol (HDL-C) and nitric oxide (NO) in both groups were significantly increased (P<0.05),and the above in-dicators with (60.74±6.86)％,(1.50±0.25) mmol·L-1 and (60.75±8.51) μmol·L-1 in ezetimibe group were significantly higher than(56.21±6.58)％,(1.34±0.22) mmol·L-1 and (56.43±6.08) μmol·L-1 in metoprolol group (t=3.352,P=0.001;t=3.076,P=0.003;t=2.645,P=0.010). The left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),to-tal cholesterol (TC),low density lipoprotein cholesterol (LDL-C),intima media thickness (IMT),plaque area,bilateral pulse wave velocity (PWV) and endothelin-1 (EF-1) in the two groups were significantly decreased after 6 months of treatment (P<0.05),and the LVESD,LVEDD,TC,LDL-C,IMT,PWV (left,right) and EF-1 with (35.72±3.65) mm,(49.03±5.43) mm,(4.36±0.56) mmol·L-1,(2.58±0.41) mmol·L-1,(0.87±0.12) mm,(1.54±0.23) mm2,(1022.87±199.54,1208.41±241.60) cm·s-1 and (57.83±7.61) ng·L-1 in ezetimibe group were significantly lower than (37.45±3.18) mm,(52.39±5.83) mm,(4.71±0.67) mmol·L-1,(2.80±0.43) mmol·L-1,(1.01±0.27) mm,(2.65±1.08) mm2,(1244.41±213.88,1347.19±263.15) cm·s-1 and (68.53±9.04) ng·L-1 in metopro-lol group (t=5.417,P<0.001;t=3.851,P<0.001;t=2.566,P=0.012;t=2.371,P=0.020;t=3.034,P=0.003;t=6.437,P<0.001;t=4.850,P<0.001;t=2.487,P=0.015;t=5.798,P<0.001). During treatment,there were no statistical differences in the incidence of MACE and adverse drug reactions between ezetimibe group and metoprolol group ((4.88％,2/41 vs 9.76％,4/41);(14.63％,6/41 vs 12.20％,5/41)) (x2=0.180,P=0.672;x2=0.105,P=0.746). Conclusion Metoprolol combined with ezetimibe can effectively improve the cardiac func-tion,regulate the lipid metabolism,improve the vascular endothelial function in elderly CHD patients with heart failure,with high safety.
Keywords：ElderlyCoronary heart diseaseEzetimibeMetoprololLipid metabolismCardiac functionVascular endothelial function
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 685-690 )