Abstract 16056: Ezetimibe Increases Reverse Cholesterol Transport in Humans

Introduction: Ezetimibe improves cardiovascular outcomes when added to optimum statin treatment. Although ezetimibe reduces LDL, it also lowers intestinal cholesterol absorption but the exact effects on fecal endogenous cholesterol excretion and turnover of cholesterol pools are not known. Hypothesis: Ezetimibe increases fecal endogenous cholesterol excretion and increases turnover of rapidly-mixing plasma cholesterol pool. Methods: In a randomized, double-masked parallel trial in 24 healthy subjects with LDL 100-190 mg/dL, we measured cholesterol metabolism before and after a 4-week treatment with either ezetimibe 10 mg/day or placebo. For each test, 40 mg cholesterol-d7 solubilized in Intralipid®, prepared using Current Good Manufacturing Practices, was infused intravenously as a bolus to label endogenous cholesterol. After 2 weeks cholesterol-d5 and sitostanol-d4 solubilized in oil were given orally to label dietary cholesterol and stool was collected on a metabolic kitchen diet controlling cholesterol...