Comparative efficacy of the addition of ezetimibe to statin<i>vs</i>statin titration in patients with hypercholesterolaemia: systematic review and meta-analysis

Mikhailidis, Dimitri P.; Lawson, Richard W.; McCormick, Anna-Louise; Sibbring, Gillian C.; Tershakovec, Andrew M.; Davies, Glenn; Tunceli, Kaan

doi:10.1185/03007995.2011.571239

Cited by 77 publications

(44 citation statements)

References 38 publications

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“…In order to compare the intensity of the different lipid-lowering medication, the theoretical percentage of LDL-c reduction was used. The theoretical percentage of LDL-c reduction was gathered from available literature on the efficacy of statins and other lipidlowering drugs (16)(17)(18). The current study defined intensive lipid-lowering therapy as therapy with a theoretical reduction of $40% in LDL-c levels (e.g., rosuvastatin in all doses, atorvastatin $20 mg, and simvastatin $40 mg).…”

Section: Intensity Of Lipid-lowering Therapymentioning

confidence: 99%

HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes

et al. 2016

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OBJECTIVETo evaluate whether low HDL cholesterol (HDL-c) levels are a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes and whether it remains a residual risk factor when attaining low LDL cholesterol (LDL-c) treatment goals or when LDL-c is treated with intensive lipid-lowering therapy. RESEARCH DESIGN AND METHODSWe performed a prospective cohort study of 1,829 patients with type 2 diabetes included in the Second Manifestations of ARTerial disease (SMART) cohort. Cox proportional hazard models were used to evaluate the risk of HDL-c on cardiovascular events and all-cause mortality. Analyses were performed in strata of LDL-c levels (<2.0, 2.0-2.5, and >2.5 mmol/L) and lipid-lowering therapy intensity and were adjusted for age, sex, BMI, smoking, alcohol, LDL-c, triglycerides, systolic blood pressure, estimated glomerular filtration rate, glucose, and HbA 1c . RESULTSA total of 335 new cardiovascular events and 385 deaths occurred during a median follow-up of 7.0 years (interquartile range 3.9-10.4). No relation was found between plasma HDL-c and cardiovascular events (hazard ratio [HR] 0.97, 95% CI 0.93-1.01) or all-cause mortality (HR 0.99, 95% CI 0.96-1.03). Subgroup analysis supported effect modification by plasma LDL-c levels. In patients with LDL-c levels <2.0 mmol/L, higher HDL-c was related to higher risk for all-cause mortality (HR 1.14, 95% CI 1.07-1.21). Higher HDL-c was also related to higher risk for cardiovascular events in patients with LDL-c levels <2.0 mmol/L (HR 1.10, 95% CI 1.07-1.21) in contrast to patients with LDL-c levels between 2.0 and 2.5 mmol/L (HR 0.85, 95% CI 0.75-0.95) and >2.5 mmol/L (HR 0.96, 95% CI 0.91-1.00). CONCLUSIONSIn high-risk patients with type 2 diabetes with LDL-c levels <2.0 mmol/L, higher HDL-c at baseline is unexpectedly related to a higher risk for cardiovascular events and all-cause mortality in contrast to high-risk patients with type 2 diabetes with LDL-c levels between 2.0 and 2.5 mmol/L.As a result of aging, urbanization, and associated lifestyle changes, the prevalence of type 2 diabetes is globally increasing (1). In an attempt to lower the high risk for cardiovascular disease in patients with type 2 diabetes, emphasis has been placed on improving glycemic control, lowering blood pressure, and improving the dyslipidemia

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Section: Intensity Of Lipid-lowering Therapymentioning

confidence: 99%

HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes

et al. 2016

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“…Therefore, the additional use of ezetimibe should be considered in the elderly in order to achieve the 'difficult' LDL-C targets proposed by the recent ESC/EAS guidelines. [14] In this context, novel treatment modalities, such as antibodies against PCSK9, are promising therapeutic options on lowering LDL-C in the future. [15] High BP is a well-established independent risk factor for CV disease and its prevalence increases with age, since more than 60% of individuals older than 65 years old are diagnosed with hypertension.…”

Section: Attainment Of Multi-factorial Treatment Targetsmentioning

confidence: 99%

Attainment of multifactorial treatment targets among elderly in a lipid clinic

et al. 2015

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“…In this metaanalysis, elevations of plasma CK and/or AST/ALT were not different between groups 32 . In another meta-analysis of 13 studies (5080 hypercholesterolaemic patients) adding ezetimibe 10 mg/day to a statin was more effective in decreasing LDL-C levels and attaining LDL-C goals compared with doubling the statin dose 33 . The weighed mean difference for LDL-C reduction was 15.3% in favour of combination treatment 33 .…”

Section: Efficacymentioning

confidence: 99%

Therapeutic options for statin-intolerant patients

Kostapanos

Athyros

Karagiannis

et al. 2012

Current Medical Research and Opinion

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Comparative efficacy of the addition of ezetimibe to statinvsstatin titration in patients with hypercholesterolaemia: systematic review and meta-analysis

Abstract: Meta-analyses were restricted by the limited number of studies with similar trial design and method of statin titration. Results indicate that add-on ezetimibe is significantly more effective in reducing LDL-C levels than doubling statin dose, enabling more patients to achieve LDL-C goal.

Cited by 77 publications

References 38 publications

HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes

HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes

Attainment of multifactorial treatment targets among elderly in a lipid clinic

Therapeutic options for statin-intolerant patients

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