Lipid Science & Technology

Biography

Biography: Ikuo Yokoyama

Abstract

The effectiveness of anti-hyperlidemia therapy for preventing cardiovascular events and inducing regression of coronary artery stenosis has been demonstrated. Multicenter trials have indicated that hydroxymethylglutaryl coenzyme A reductase inhibitors (so-called statins) aid in preventing coronary artery disease (CAD). Furthermore, one statin has been reported to be more effective in reducing the occurence of cardiovascular events than percutaneous transluminal coronary revascularisation therapy. However, despite the fact that statins are currently the mainstay of dyslipidemia care, their efficacy in preventing a cardiovascular event still has limitations. This is because the ability of the statin to inhibit cholesterol production might exert adverse effects by restoring cholesterol levels via activation of reuptake of cholesterol derived from the small intestine. Ezetimibe has recently emerged as a new class of lipid-lowering medication, which acts via the inhibition of Niemann-Pick C1 Like 1, a protein localized in jejunal enterocytes. Combination therapy with ezetimibe and statins has been shown to be highly effective in the treatment of hypercholesterolemia. However, to date it has not been established whether ezetimibe combined with statin therapy has a much stronger effect than that of low density lipoprotein bound cholesterol (LDL)-apheresis, which is recognized as the most effective therapy for hyperlipidemia. I experienced a rare case in which ezetimibe appeared to play a central role, in place of LDL-apheresis, in a patient with familial hypercholesterolemia and CAD who had undergone coronary artery bypass grafting. This case is discussed here to increase our knowledge of ezetimibe and lipid care