BACKGROUND: Many 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.
METHODS: Plasma 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: 20mg/day rosuvastatin, 40mg/day atorvastatin, and combined 
10mg/day atorvastatin with 10mg/day ezetimibe. The following parameters were 
studied: activity of acetylcholinesterase (AChE) and butyrylcholinoesterase 
(BChE) and lipid levels.
RESULTS: Patients 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.
CONCLUSIONS: Our 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.