Cardiovascular benefits of statin plus ezetimibe combination therapy versus statin monotherapy in acute coronary syndrome: a meta-analysis of randomized controlled trials.
| Autor: | de Oliveira Almeida G; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Balieiro C; Department of Medicine, State University of Amazonas, Manaus., Bertoli ED; Department of Medicine, University of South Santa Catarina, Palhoça., Moreira MEL; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Silva ALS; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Minucci BS; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Zapparoli I; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Maluf MS; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Carvalho HCP; Department of Medicine, Federal University of Triângulo Mineiro, Uberaba., Dos Santos Borges R; Department of Medicine, Federal University of Minas Gerais, Belo Horizonte., Pasqualotto E; Department of Medicine, Federal University of Santa Catarina, Florianópolis., Nienkötter T; Department of Medicine, University of South Santa Catarina, Palhoça., Alves V; Department of Medicine, University of São Paulo., Guida CM; Division of Cardiology, Department of Cardiology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Coronary artery disease [Coron Artery Dis] 2025 Jan 01; Vol. 36 (1), pp. 9-17. Date of Electronic Publication: 2024 Sep 06. |
| DOI: | 10.1097/MCA.0000000000001407 |
| Abstrakt: | Background: The efficacy of adding ezetimibe to statin therapy for event reduction in patients with acute coronary syndromes (ACS) remains a topic of ongoing debate. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ezetimibe plus statin versus statin monotherapy in patients with ACS. We searched PubMed, Embase, and Cochrane for eligible trials. The random-effects model was used to calculate the risk ratios with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3 (RStudio, PBC). Results: Six RCTs comprising 20 574 patients with ACS were included, of whom 10 259 (49.9%) were prescribed ezetimibe plus statin. The patient population had an average age of 63.8 years, and 75.1% were male. Compared with statin monotherapy, ezetimibe plus statin significantly reduced major adverse cardiovascular events (MACE) (risk ratio 0.93; 95% CI 0.90-0.97; P < 0.01) and nonfatal myocardial infarction (risk ratio 0.88; 95% CI 0.81-0.95; P < 0.01). There was no significant difference between groups for revascularization (risk ratio 0.94; 95% CI 0.90-1.00; P = 0.03), all-cause mortality (risk ratio 0.87; 95% CI 0.63-1.21; P = 0.42), or unstable angina (risk ratio 1.05; 95% CI 0.86-1.27; P = 0.64). Conclusion: In this meta-analysis of patients with ACS, the combination of ezetimibe plus statin was associated with a reduction in MACE and nonfatal myocardial infarction, compared with statin monotherapy. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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