BACKGROUND: Statins have favourable effects on lipid profiles, decrease total mortality and have many pleiotropic effects.AIMS: To determine and compare the pleiotropic effects of simvastatin and ezetimibe in dyslipidaemic patients.METHODS: Forty-four patients (20 postmenopausal women) with low-density lipoprotein cholesterol >130 mg/dL (or >100mg/dL in patients with coronary artery disease or its equivalent) were treated with simvastatin 10mg daily (n = 21) or ezetimibe 10mg daily (n = 23). In blood samples taken before and three months after treatment, we measured the concentration of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B, lipoprotein(a), homocysteine, tissue factor, von Willebrand's factor and C-reactive protein.RESULTS: Baseline lipid profiles and haematological variables were similar in both groups. Simvastatin and ezetimibe decreased the concentrations of total cholesterol (262 to 189 mg/dL, p < 0.001, and 268 to 220 mg/dL, p = 0.001, respectively), low-density lipoprotein cholesterol (177 to 114 mg/dL, p < 0.001 and 196 to 146 mg/dL, p < 0.001, respectively) and C-reactive protein (1.2 to 0.3 mg/dL, p = 0.001 and 2.8 to 0.8 mg/dL, p = 0.005, respectively). Simvastatin also reduced the concentration of apolipoprotein B (125 to 93 mg/dL, p < 0.001).CONCLUSION: Both drugs improved lipid profiles and C-reactive protein concentration. However, no influence was found on tissue factor or von Willebrand's factor. Our results suggest that C-reactive protein lowering may occur in conjunction with low-density-lipoprotein cholesterol lowering and not through a specific statin pleiotropic anti-inflammatory effect.