Effect of coadministration of ezetimibe with statin therapy versus statin therapy alone on flow mediated vasodilation in patients with coronary artery disease

ISRCTN ISRCTN34110682
DOI https://doi.org/10.1186/ISRCTN34110682
Secondary identifying numbers N/A
Submission date
13/09/2008
Registration date
17/09/2008
Last edited
17/09/2008
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Ascan Warnholtz
Scientific

Johannes Gutenberg-Universität Mainz
Department of Medicine II
Langenbeckstrasse 1
Mainz
D-55131
Germany

Study information

Study designPhase IV, double-blind, two-arm, parallel-group, randomised controlled trial (single-centre)
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Scientific title
Study acronymCEZAR
Study objectivesAtorvastatin 80 mg per day is more effective in the improvement of flow-mediated dilation of the right brachial artery than atorvastatin 10 mg plus ezetimibe 10 mg per day despite comparable reduction of plasma low-density lipoprotein (LDL) cholesterol concentration.
Ethics approval(s)1. Ethics Committee of the Medical Association of Hamburg (Ethik-Kommission der Ärztekammer Hamburg), approved on 13/03/2003
2. State Medical Board of Registration in Rhineland-Palatinate (Landesärztekammer Rhineland-Palatinate), approved on 07/11/2005
Health condition(s) or problem(s) studiedStable coronary artery disease
InterventionArm 1: Atorvastatin (oral) 80 mg per day for 8 weeks
Arm 2: Atorvastatin (oral) 10 mg + ezetimibe (oral) 10 mg per day for 8 weeks

Ultrasonic measurements of endothelial function were carried out at the beginning of treatment and at the end of the 8-week pharmacological intervention.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Ezetimibe and atorvastatin
Primary outcome measureEffect of treatment on the absolute change (in percentage) in flow-mediated dilation (FMD) at 8 weeks compared to baseline.
Secondary outcome measuresEffect of treatment, at 8 weeks compared to baseline, on the following:
1. Absolute change (in percentage) in nitroglycerin-mediated dilation (NMD)
2. Absolute change in LDL cholesterol plasma concentration
3. Absolute change in C-reactive protein plasma concentration
4. Absolute change in uric acid plasma concentration
5. Absolute change in 8-iso-prostaglandin F2 alpha urine concentration
Overall study start date01/07/2003
Completion date31/07/2006

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants58
Key inclusion criteria1. Both males and females, over 18 years old
2. Angiographic, documented coronary heart disease with:
a. Generalized wall irregularities (stenosis <40%) and/or
b. Existence of at least one stenosis >50%
3. Endothelial dysfunction with flow-dependent dilation of the brachial artery of <6%
4. LDL cholesterol >100 mg/dl
5. Written consent of the patients for participation in the study
Key exclusion criteria1. Acute coronary syndrome
2. Stroke or peripheral revascularisation within 12 weeks before study enrolment
3. Known intolerance towards HMG CoA reductase inhibitors or ezetimibe
4. Clinically significant valvular disease
5. Hypertrophic obstructive cardiomyopathy
6. Sustained ventricular arrhythmias
7. Syncope within four weeks before the study
8. Severe respiratory disease
9. Unstable diabetes mellitus requiring frequent adjustments in insulin doses
10. Known hypothyroidism
11. Known hyperthyroidism
12. Gastrointestinal disorders (such as Crohn's disease), which could lead to decreased absorption of the study drug
13. Chronic liver disease
14. History of pancreatitis
15. History of organ transplantation
16. Clinically significant heart failure with left ventricular ejection fraction of <30%
17. Symptoms of orthostatic hypotension, or a systolic blood pressure in the supine position of <90 mmHg
18. Systolic blood pressure >180 mmHg and/or diastolic blood pressure >105 mmHg despite antihypertensive therapy
19. Elevated serum creatinine of >2.0 mg/dL or known nephrotic syndrome
20. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >1.5 times above the upper normal limit
21. Triglyceride level >400 mg/dl
22. Treatment with an HMG CoA reductase inhibitor during the last three months
23. Treatment with ezetimibe during the last three months
24. Initiation of treatment with an angiotensin converting enzyme (ACE) inhibitor, AT1-receptor antagonist, or calcium channel blocker within the past four weeks
25. Treatment with fibrates or colestipol during the last three months
26. Current treatment with macrolide antibiotics, niacin or antimycotics of azole type
27. Expected problems with compliance or follow-up visits (no fixed residence, alcohol or drug abuse, history of failure of medical advice, psychiatric diseases, etc.)
28. For women: pregnancy, breast feeding or possible pregnancy (women of childbearing age on an acceptable method of contraception may be included)
29. Simultaneous participation in another study
30. Therapy with another investigational product within a period of 30 days before the study
Date of first enrolment01/07/2003
Date of final enrolment31/07/2006

Locations

Countries of recruitment

  • Germany

Study participating centre

Johannes Gutenberg-Universität Mainz
Mainz
D-55131
Germany

Sponsor information

Johannes Gutenberg-University Mainz (Germany)
University/education

c/o Prof. Dr. T. Münzel
Department of Medicine II
Langenbeckstrasse 1
Mainz
D-55101
Germany

Website http://www.uni-mainz.de/eng
ROR logo "ROR" https://ror.org/023b0x485

Funders

Funder type

University/education

University of Hamburg (Germany)

No information available

Johannes Gutenberg-University Mainz (Germany)
Government organisation / Universities (academic only)
Alternative name(s)
Johannes Gutenberg University of Mainz, University of Mainz, Johannes Gutenberg University Mainz, JGU
Location
Germany

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan