Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Dec 15;225:50-59.
doi: 10.1016/j.ijcard.2016.09.082. Epub 2016 Sep 28.

Clinical Outcome of Statin Plus Ezetimibe Versus High-Intensity Statin Therapy in Patients With Acute Myocardial Infarction Propensity-Score Matching Analysis

Affiliations
Comparative Study

Clinical Outcome of Statin Plus Ezetimibe Versus High-Intensity Statin Therapy in Patients With Acute Myocardial Infarction Propensity-Score Matching Analysis

Mi Seon Ji et al. Int J Cardiol. .

Abstract

Background: It is unclear whether simvastatin-ezetimibe could be an alternative therapy to high-intensity statin therapy in high-risk patients. The aim of this study was to compare the clinical outcomes of simvastatin-ezetimibe and high-intensity statin therapy in patients with acute myocardial infarction (AMI), and especially in those with high-risk factor.

Methods: A total of 3520 AMI patients in the KAMIR (Korea Acute Myocardial Infarction Registry) were classified into simvastatin-ezetimibe group (n=1249) and high-intensity statin group (n=2271). Multivariate analysis and propensity-score matching analysis were performed. The primary endpoint was major adverse cardiac events (MACE) at 12-months follow-up.

Results: In overall AMI patients, MACE occurred in 116 patients (9.3%) in simvastatin-ezetimibe group and 116 patients (5.1%) in high-intensity statin group. The difference in MACE between groups was driven by repeat revascularization (5.9% vs. 2.2%). After propensity matching analysis, simvastatin-ezetimibe was associated with a higher incidence of MACE than high-intensity statin therapy (adjusted hazard ratio: 3.090, 95% confidence interval: 1.715 to 5.566, p<0.001). However, in patients with high-risk factors, such as diabetes, old age, or heart failure, simvastatin-ezetimibe had similar incidence of MACE compared with high-intensity statin therapy in further adjusted analysis.

Conclusions: In overall AMI patients, high-intensity statin therapy had better clinical outcomes than simvastatin-ezetimibe. However, in patients with high-risk factor, simvastatin-ezetimibe had comparable clinical outcomes to high-intensity statin therapy. Therefore, simvastatin-ezetimibe could be used as an alternative to high-intensity statin therapy in such patients.

Keywords: Ezetimibe simvastatin combination; Myocardial infarction; Statins.

Similar articles

See all similar articles

Cited by 4 articles

Publication types

MeSH terms

Substances

Feedback