Original articleEffect of intensive lipid-lowering therapies on cholinesterase activity in patients with coronary artery disease

BackgroundMany disease entities, including coronary artery disease (CAD), demonstrate abnormalities in the activity of cholinesterases. As CAD is characterized by an increase in cholesterol level, patients with this disease are treated with lipid-lowering drugs. The present study attempts to determine how statin or combined statin and ezetimibe therapy influences cholinesterase activity.MethodsPlasma and erythrocytes were isolated from the peripheral blood of CAD patients (n = 61) and healthy subjects (n = 63). The patients were randomized into three groups: 20 mg/day rosuvastatin, 40 mg/day atorvastatin, and combined 10 mg/day atorvastatin with 10 mg/day ezetimibe. The following parameters were studied: activity of acetylcholinesterase (AChE) and butyrylcholinoesterase (BChE) and lipid levels.ResultsPatients with CAD demonstrated significant increase in AChE and BChE activity. We observed increase in the level of low-density lipoprotein cholesterol (LDL) and triglycerides (TG) level, and decrease in high density lipoprotein cholesterol (HDL) level. After atorvastatin monotherapy, the following decrease in activity were observed: 17% LDL, 43% total cholesterol (TC) level, 33% AChE and 17% BChE. The following decrease in activity were observed following rosuvastatin monotherapy: 26% LDL level, 26% AChE and 18% BChE. After combined atorvastatin + ezetimibe therapy, the following decrease in activity occurred: 27% of LDL level, 15% TC, 33% of AChE and 20% BChE.ConclusionsOur results suggest that intensive lipid-lowering therapy has a beneficial effect on AChE and BChE activity and lipid levels. Combination atorvastatin + ezetimibe therapy was found to have similar effects on the tested parameters as statin monotherapy.