Better Results

A different type of cholesterol-lowering drug adds to statin's reduction of CVD risk




Adding another type of cholesterol-lowering drug to statin therapy may help prevent heart attacks and strokes in high-risk patients with acute coronary syndrome (ACS). That was the finding in a large, long-term study presented at the American Heart Association’s Scientific Sessions 2014.

Compared to patients with coronary heart disease given the drug simvastatin plus a placebo, those given both simvastatin and the non-statin drug ezetimibe had:

⇒ A 6.4 percent lower risk of all cardiovascular events

⇒ A 14 percent lower risk of all heart attacks

⇒ A 14 percent lower risk of stroke

⇒ A 21 percent lower risk of ischemic stroke.

"This study is the first to show that adding a non-statin drug to a statin to improve cholesterol levels can help patients with specific heart problems do better," said Christopher P. Cannon, M.D. He is the lead author, a professor of medicine at Harvard Medical School, and a physician at Brigham and Women’s Hospital.

The study was done at 1,158 centers in 39 countries. It enrolled 18,144 patients with acute coronary syndrome who were age 50 or older. (Acute coronary syndrome is an umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked, such as heart attack or unstable angina.) The patients also had low-density lipoprotein (LDL) cholesterol levels at or less than 125—or at or less than 100 if they were already using a statin.

Statins, such as simvastatin, block cholesterol production in the liver. Ezetimibe, a cholesterol absorption inhibitor, reduces how much cholesterol the body absorbs in the intestine. In the study, the dual therapy reduced patients’ bad cholesterol (LDL) to an average of 54 mg/dL, compared with 69 for patients treated with the statin and placebo.

"We took those patients from a clinically appropriate target LDL-C to even lower. We now have solid evidence that lower is good, and even lower can be even better," Cannon said.

Find more on this study.

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