The Vytorin on Carotid–Media Thickness and Overall Arterial Rigidity (VYCTOR) study

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Evaluation of: Meaney A, Ceballos G, Asbun J et al. The Vytorin on Carotid Intima-Media Thickness and Overall Arterial Rigidity (VYCTOR) Study. J. Clin. Pharmacol. 49(7), 838–847 (2009).The Vytorin on Carotid–Media Thickness and Overall Arterial Rigidity (VYCTOR) study was designed to assess the clinical effect of three lipid-lowering treatment regimens on carotid intima–media thickness. The study was designed to analyze 90 high-risk patients who were initially randomly allocated to three treatment groups; pravastatin 40 mg/day (group A), simvastatin 40 mg/day (group B), and simvastatin 20 mg/day plus ezetimibe 10 mg/day (group C) as initial therapy. The therapeutic goals were less than 100 mg/dl LDL-cholesterol in subjects with coronary disease or less than 70 mg/dl in high-risk subjects. Titration of the pharmacologic doses was allowed if therapeutic goals were not achieved. Subjects randomized to receive pravastatin (group A) were allowed to add 10 mg of ezetimibe to the baseline therapy. Patients in group B were titrated to 80 mg of simvastatin. Group C received simvastatin 40 mg/day and ezetimibe 10 mg/day. The primary end point of the trial was pharmacologic alteration of intima–media thickness over a 12-month trial period. Several secondary end points were also analyzed, including changes in LDL-cholesterol and high-sensitivity C-reactive protein. Additionally, alteration of arterial stiffness was also analyzed. Significant reductions in carotid intimal thickness and LDL-cholesterol levels (60%) were acheived with aggressive lipid-lowering therapy. The VYCTOR study did not reveal significant differences in C-reactive protein, HDL, triglycerides, blood pressure or BMI between groups.

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