In a nutshell
This paper studied whether a combination of ezetimibe (Zetia) plus statin treatment is beneficial to patients with acute coronary syndrome (disorders caused by reduced blood flow to the heart).
Some background
Statins are a group of drugs that reduce levels of low-density lipoprotein (LDL) cholesterol (fatty substance that builds up in the blood vessels). Reducing the level of LDL cholesterol reduces the risk of cardiovascular events such as strokes and heart attacks. Statins are medications that lower LDL cholesterol. However, there are safety concerns with intensive statin therapy.
Ezetimibe is a drug that reduces absorption of cholesterol from the intestine. When combined with statins, ezetimibe reduces LDL cholesterol levels by an additional 23%. However, it is unknown whether this lowering of cholesterol levels will reduce the rates of heart attack and stroke in patients.
Methods & findings
In the current study, 9067 patients received simvastatin (a statin) plus ezetimibe (Group 1). 9077 patients received simvastatin plus placebo (drug that has no real effect, Group 2).
After 1 year, levels of LDL cholesterol were significantly lower in Group 1 than in Group 2. The addition of ezetimibe lowered LDL cholesterol 24% more than simvastatin alone.
The risk of heart attack was 13% lower and the risk of ischemic stroke (blockage of blood vessels to the brain by blood clots) was 21% lower in Group 1 compared to Group 2. The risk of death from cardiovascular causes was 10% lower in Group 1 than Group 2. A combination of simvastatin and ezetimibe was more significantly beneficial to patients with diabetes mellitus and patients 75 years or older.
10.6% of Group 1 and 10.1% of Group 2 stopped taking the medication due to an adverse event (undesired effect of treatment). Adverse events included muscle weakness, liver damage, gallbladder damage and cancer.
The bottom line
The authors concluded that adding ezetimibe to statin treatment further lowered the risk of strokes, heart attacks and death.
The fine print
A number of patients stopped receiving medication during the study which may affect the results.
This study was funded by Merck, the manufacturer of ezetimibe.
What’s next?
Talk to your doctor about receiving ezetimibe in addition to statin.
Published By :
The New England Journal of Medicine
Date :
Jun 03, 2015
