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Does the addition of ezetimibe to statins reduce cardiovascular risk?

Francisca I Araya1, Bruno Grassi2

  • 1Proyecto Epistemonikos, Santiago, Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago Centro, Chile.

Medwave
|December 7, 2016
PubMed

Insights

Adding ezetimibe to statins likely offers minimal impact on overall mortality for patients. This combination may slightly decrease risks of heart attack and stroke, though evidence certainty is low.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Statins are primary lipid-lowering agents for cardiovascular risk reduction.
  • Many patients do not achieve guideline-recommended lipid goals with statins alone.
  • Residual cardiovascular risk persists even in patients at goal.

Purpose of the Study:

  • To evaluate the efficacy and safety of adding ezetimibe to statin therapy.
  • To synthesize current evidence on ezetimibe-statin combination therapy.

Main Methods:

  • Systematic review and meta-analysis of 67 trials.
  • Evidence synthesized using the GRADE approach for certainty assessment.

Main Results:

  • Adding ezetimibe to statins showed little to no difference in overall mortality.
  • A potential small reduction in myocardial infarction and stroke risk was observed.
  • The certainty of evidence for these outcomes was rated as low.

Conclusions:

  • Ezetimibe addition to statins may offer a slight benefit in reducing cardiovascular events.
  • Further high-certainty evidence is needed to confirm the benefits of ezetimibe-statin therapy.

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