AI Article Synopsis
- Current guidelines recommend intensive lipid-lowering therapy for high-risk cardiovascular patients, and there's research suggesting that adding ezetimibe to statins may affect plaque changes, though results vary.
- A systematic review of eight studies, involving 583 subjects, showed that combining ezetimibe with statins significantly reduced total atheroma volume and LDL cholesterol levels.
- The study findings indicated a notable decrease in total atheroma volume and LDL-C, with ezetimibe proving to be an effective addition to statin therapy.
Article Abstract
Background: Current guidelines recommend an intensive lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) target in patients with high risk of cardiovascular disease. Former studies suggested adding ezetimibe to statin therapy in the above setting may promote plaque changes; however, this effect has not been consistently reported.
Methods: Electronic searches were performed in MEDLINE, EMBASE, and Cochrane library on November 30, 2017 to identify prospective trials assessing the effects of combined ezetimibe and statin therapy versus statin therapy alone on atheroma volume using intravascular ultrasound. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random-effects model.
Results: Eight studies were obtained for systematic review and 6 of them compromising total of 583 subjects that meet the criteria were meta-analyzed. There was a significant reduction from baseline to follow-up in total atheroma volume with an MD of -3.71 mm (95% confidence interval: -5.98 to -1.44, P < .001), whereas analysis for percent atheroma volume demonstrated weighted MD of - 0.77% (-1.68 to 0.14, P = .10). A substantial decrease in LDL-C was observed with MD -16.75 mg/dL (-20.89 to -12.60, P < .00001).
Conclusion: The addition of ezetimibe to statin therapy is effective in reducing total atheroma volume assessed by intravascular ultrasound and also resulted in effective reduction of plasma LDL-C levels.
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| http://dx.doi.org/10.1016/j.jacl.2018.06.001 | DOI Listing |
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