Journal Article

Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes

Giugliano, Robert P, Cannon, Christopher P, McCagg, Amy, Darius, Harald, Jukema, J. Wouter, De Ferrari, Gaetano M, White, Jennifer A, Musliner, Thomas A, Theroux, Pierre, Tershakovec, Andrew M, Lewis, Basil S, Ophuis, Ton Oude, Ruzyllo, Witold, Im, KyungAh, Califf, Robert M, Blazing, Michael A, Reist, Craig, De Lucca, Paul, Wiviott, Stephen D, Bohula, Erin A, Braunwald, Eugene

2015

Overview

In this trial, patients with an acute coronary syndrome within the previous 10 days were randomly assigned to simvastatin plus either ezetimibe or placebo. At a median of 6 years, the rate of cardiovascular events was modestly but significantly lower with simvastatin–ezetimibe. The use of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) reduces both low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events in patients with and those without cardiovascular disease. 1 – 4 Intensive statin therapy, as compared with moderate-dose statin therapy, incrementally lowers LDL cholesterol levels and rates of nonfatal cardiovascular events. 5 – 9 Because of the residual risk of recurrent cardiovascular events and safety concerns associated with high-dose statin therapy, 10 additional lipid-modifying therapies have been sought. 11 – 14 Ezetimibe targets the Niemann–Pick C1–like 1 (NPC1L1) protein, thereby reducing absorption of cholesterol from the intestine. 15 , 16 When added to statins, ezetimibe reduces LDL cholesterol . . .

• Publisher: Massachusetts Medical Society
• Subject: Acute Coronary Syndrome - drug therapy / Acute coronary syndromes / Aged / AGG2FN16EV (Simvastatin) / Angina / Anticholesteremic Agents / Anticholesteremic Agents - adverse effects / Anticholesteremic Agents - therapeutic use / Anticholesteremic Agents/adverse effects/therapeutic use / Azetidines / Azetidines - adverse effects / Azetidines - therapeutic use / Azetidines/adverse effects/therapeutic use / Cancer / Cardiology and cardiovascular system / Cardiovascular & respiratory systems / Cardiovascular diseases / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Cardiovascular Diseases/epidemiology/mortality/prevention & control / Cerebral infarction / Cholesterol / Cholesterol, LDL / Cholesterol, LDL - blood / Double-Blind Method / Drug therapy / Drug Therapy, Combination / EOR26LQQ24 (Ezetimibe) / Ezetimibe / Female / Gallbladder / Human health and pathology / Human health sciences / Humans / Hydroxymethylglutaryl-CoA Reductase Inhibitors / Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects / Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use / Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/therapeutic use / Intestine / Kaplan-Meier Estimate / Life Sciences / Low density lipoprotein / Male / Middle Aged / Myocardial infarction / Pharmaceuticals / Sciences de la santé humaine / Simvastatin / Simvastatin - therapeutic use / Statins / Stroke / Systèmes cardiovasculaire & respiratoire / Triglycerides / Triglycerides - blood