AI Article Synopsis
- High-intensity statin therapy is effective in reducing mortality and cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD), but elderly patients often tolerate moderate-intensity statins better due to intolerance risks.
- A study compared the incidence of statin-associated muscle symptoms (SAMS) and low-density lipoprotein cholesterol (LDL-C) levels in elderly ASCVD patients on either high-intensity statins or moderate-intensity statins combined with ezetimibe.
- Results showed that combination therapy significantly reduced SAMS (0.7% vs 5.7%) while achieving comparable LDL-C target levels (75.4% vs 68.7%), indicating that moderate-intensity therapy with ezetim
Article Abstract
Background: High-intensity statin therapy significantly reduces mortality and cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD). However, moderate-intensity statins are often preferred for elderly patients due to their higher risk of intolerance to high-intensity statins.
Objective: To compare the incidence of statin-associated muscle symptoms (SAMS) and the effect on low-density lipoprotein cholesterol (LDL-C) levels between elderly ASCVD patients receiving high-intensity statin monotherapy and those receiving moderate-intensity statin with ezetimibe in a combination therapy.
Method: In a prospective, multicenter, open-label trial conducted in South Korea, 561 patients aged 70 years or above with ASCVD were randomly assigned to receive either moderate-intensity statin with ezetimibe combination therapy (rosuvastatin 5 mg with ezetimibe 10 mg) or high-intensity statin monotherapy (rosuvastatin 20 mg) over 6 months. The primary endpoint was the incidence of SAMS, and the key secondary endpoint was the achievement of target LDL-C levels (<70 mg/dL) within 6 months.
Results: The primary endpoint showed a lower incidence of SAMS in the combination therapy group (0.7%) compared to the high-intensity statin monotherapy group (5.7%, p = 0.005). Both groups achieved similar LDL-C levels, with 75.4% in the combination therapy group and 68.7% in the monotherapy group reaching target levels.
Conclusion: Moderate-intensity statin with ezetimibe combination therapy offers a lower risk of SAMS and similar LDL-C reduction in elderly patients with ASCVD, compared to high-intensity statin monotherapy.
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