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Statin + Ezetimibe May Benefit After Acute Coronary Syndrome

Lowering of LDL cholesterol levels, improved cardiovascular outcomes for simvastatin + ezetimibe

THURSDAY, June 4, 2015 (HealthDay News) — In treatment following acute coronary syndrome, ezetimibe added to statin therapy appears beneficial, according to a study published online June 3 in the New England Journal of Medicine.

Christopher P. Cannon, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted a randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the previous 10 days. Participants were randomized to simvastatin and ezetimibe or simvastatin and placebo. Patients were followed for a median of six years, for a primary end point of a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization, or nonfatal stroke.

The researchers found that the median time-weighted average low-density lipoprotein (LDL) cholesterol level was 53.7 and 69.5 mg/dL in the simvastatin-ezetimibe and simvastatin-placebo groups, respectively (P < 0.001). At seven years, the Kaplan-Meier event rate for the primary end point was 32.7 percent in the simvastatin-ezetimibe group and 34.7 percent in the simvastatin-placebo group (hazard ratio, 0.936; 95 percent confidence interval, 0.89 to 0.99; P = 0.016). In the two groups the rates of prespecified muscle, gallbladder, and hepatic adverse effects and cancer were similar.

“When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes,” the authors write.

The study was funded by Merck, which manufactures ezetimibe.

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