Atherosclerotic Disease Molecular Genetics Research

Objectives To study the evidence on the efficacy and safety of ezetimibe co-administrated with simvatatin compared to simvatatin monotherapy.Design Meta-analysis of randomized controlled trials (RCTs).Methods Three electronic bibliographic databases covering the biomedical, scientific and grey literature were searched from inception and supplemented by contact with experts in the field. Two reviewers independently determined the eligibility of RCTs.Results A meta-analysis of seven randomized, double-blind, controlled trials (4563 people) showed that ezetimibe co-administrated with simvatatin was associated with a statistically significant mean reduction in LDL cholesterol (from baseline endpoint) of-15.12%, (95% CI:-19.50 to-10.73, P<0.0001) compared with simvatatin monotherapy. Significant changes were also found in HDL cholesterol (1.89%,95%CI:1.21 to 2.57, P<0.0001), total cholesterol (-13.5%,95%CI:-17.32 to-9.68, P<0.0001) and triglyceride levels (-3.09%,95%CI:-4.40 to-1.78, P<0.0001).Conclusions Ezetimibe co-administrated with simvatatin is effective in reducing the lipid and lipoprotein levels relative to simvatatin monotherapy. BACKGROUND:The protein of Niemann-pick type C1 gene (NPCl) is known to facilitate the egress of cholesterol and other lipids from late endosomes and lysosomes to other cellular compartments and plays critical roles in vascular injure, which is involved in the progression of coronary heart disease. This study aims to investigate whether the single-nucleotide polymorphisms (SNPs) of NPC1 are associated with risk of coronary heart disease (CHD) and to investigate the interaction between NPCl with smoking on CHD.METHODS:We performed a case-control study, including 873 patients with coronary heart disease (CHD) and 864 subjects without CHD as control. Polymorphisms of NPC1 gene were genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP).RESULTS:Patients carrying the Arg215Arg had a decrease risk of CHD as compared with those carrying genotypes His215His and His215Arg in Chinese population (odds ratios 0.647,95%CI 0.428 to 0.980, P=0.039). Moreover in smokers, carriers of NPC1 His215His and His215Arg had significantly increased age-and sex-adjusted CHD.CONCLUSIONS:These findings may provide evidence that in gene status NPC1 contributes to lipid accumulation in human macrophages and interacts with smoking environment factor in the pathogenesis of CHD.