Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis.

Autor:	Hong N; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Graduate School, Yonsei University College of Medicine, Seoul, Korea., Lee YH; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea., Tsujita K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan., Gonzalez JA; Department of Medicine (Cardiology) and Radiology, University of Virginia Health System, Charlottesville, VA, USA., Kramer CM; Department of Medicine (Cardiology) and Radiology, University of Virginia Health System, Charlottesville, VA, USA., Kovarnik T; Second Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic., Kouvelos GN; Vascular Surgery Unit, Department of Surgery, University of Ioannina, Ioannina, Greece., Suzuki H; Musashino Tokusyu Hospital, Tokyo, Japan., Han K; Department of Biostatistics, The Catholic University of Korea, Seoul, Korea., Lee CJ; Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei University College of Medicine, Seoul, Korea., Park SH; Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei University College of Medicine, Seoul, Korea., Lee BW; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea., Cha BS; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea., Kang ES; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea. edgo@yuhs.ac.
Jazyk:	angličtina
Zdroj:	Endocrinology and metabolism (Seoul, Korea) [Endocrinol Metab (Seoul)] 2018 Jun; Vol. 33 (2), pp. 219-227. Date of Electronic Publication: 2018 May 04.
DOI:	10.3803/EnM.2018.33.2.219
Abstrakt:	Background: Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes. Methods: Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin- or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression. Results: A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I²=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; P(heterogeneity)=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (β=0.87, P=0.038). Conclusion: Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs. Competing Interests: No potential conflict of interest relevant to this article was reported. (Copyright © 2018 Korean Endocrine Society.)
Databáze:	MEDLINE
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