Ezetimibe Enriched Statin therapy would benefit patients with ACS

During a new study, researchers have found that ezetimbe enriched statin therapy can benefit patients with acute coronary syndrome (ACS) after they undergo conventional treatment for the condition.

Christopher P. Cannon, one of the coauthors of the study and a MD working at the Women’s Hospital in Boston, carried out a random trial on 18,144 patients, each of whom was diagnosed with ACS and got hospitalized within the last ten days.

In addition, the LDL cholesterol levels of all these patients either varied between 50 and 100 mg per deciliter or 50 and 125 mg per deciliter depending on whether or not they were getting treated with conventional lipid lowering medications.

During the study, the patients were either given simvastatin (40mg) and ezetimibe (10mg) or only simvastatin along with placebo. The researchers monitored the patients for six years. During this period the participating patients experienced the following: unstable angina, cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization.


During these six years the average LDL levels in patients treated with the combination of simvastatin and ezetimibe remained just 53.7 mg per deciliter. Patients treated with simvastatin and placebo, on the other hand, had average LDL cholesterol reading of 69.5 mg per deciliter.

On the seven year mark, researchers found that the Kaplan-Meier event rate has become 34.7 in patients treated with simvastatin and placebo. During the same phase, the rate was just 32.7% in patients undergoing simvastatin-ezetimibe therapy. This finding marked a risk difference of as much as 2% between the two groups, which, according to medical practitioners, is pretty significant.


So, how does ezetimibe work when administered in combination with statin? Addition of ezetimibe in standard statin therapy results in incremental lowering of the levels of low density lipoprotein. In addition, the combination therapy was found to improve the patients’ cardiovascular outcome significantly. What’s more, the LDL levels of those patients became lower even than the previous targets.

Here it must be mentioned that the previously specified rates of gallbladder disorder, cancer and muscular and hepatic adverse effects remained the same in both groups. You can read the entire paper on the June 3 edition of the widely read general medical journal New England Journal of Medicine (NEJM).