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Comparative effectiveness of atorvastatin monotherapy vs. atorvastatin plus bempedoic acid combination in patients
Laith Rhabneh1, Ra'ed Ababneh1, Ibrahim Alnaser2
1INTERNAL MEDICINE DEPARTMENT, HACKENSACK MERIDIAN OCEAN UNIVERSITY MEDICAL CENTER, BRICK TOWNSHIP, UNITED STATES.
Insights
Adding bempedoic acid to atorvastatin therapy significantly reduces major adverse cardiovascular events (MACE), cardiac arrest, and hospitalizations in coronary artery disease (CAD) patients. This combination therapy demonstrated a protective effect without increasing the risk of myopathy.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Clinical Research
Background:
- Established coronary artery disease (CAD) necessitates effective lipid-lowering strategies.
- Atorvastatin is a common treatment, but additional therapies may be required to optimize cardiovascular outcomes.
- The role of bempedoic acid in combination with statins warrants investigation for enhanced cardiovascular protection.
Purpose of the Study:
- To evaluate the impact of adding bempedoic acid to atorvastatin therapy on cardiovascular outcomes.
- To assess the effect on major adverse cardiovascular events (MACE), cardiac arrest, and all-cause hospitalization.
- To determine the incidence of myopathy in patients receiving combination therapy versus atorvastatin monotherapy.
Main Methods:
- A retrospective cohort study utilizing the TriNetX global health research network.
- Patients with established CAD were divided into atorvastatin monotherapy and atorvastatin plus bempedoic acid cohorts.
- Propensity score matching was used to ensure balanced baseline characteristics between the two groups.
Main Results:
- The combination therapy group (atorvastatin + bempedoic acid) showed a significantly lower incidence of MACE (3.2% vs. 5.7%).
- Hazard ratios indicated reduced risk for cardiac arrest (HR 1.628) and all-cause hospitalizations (HR 1.418) with combination therapy.
- No significant difference in the incidence of myopathy was observed between the atorvastatin monotherapy and combination therapy groups.
Conclusions:
- Adding bempedoic acid to atorvastatin therapy provides a significant protective effect against major adverse cardiovascular events in CAD patients.
- The combination therapy reduces cardiac arrest and hospitalizations without a statistically significant increase in myopathy.
- Further prospective studies are recommended to validate these findings on cardiovascular outcomes.
Objective:
Aim: To evaluate the impact of adding bempedoic acid to atorvastatin therapy on cardiovascular outcomes, including major adverse cardiovascular events (MACE), cardiac arrest, all-cause hospitalization, and myopathy, in patients with established coronary artery disease.
Patients And Methods:
Materials and methods: We conducted a retrospective cohort study using the TriNetX global health research network. Patients with established CAD were categorized based on their antilipemic therapy into two cohorts: atorvastatin monotherapy and atorvastatin plus bempedoic acid. Propensity score matching was employed to balance baseline characteristics between the cohorts. The primary outcome was the occurrence of MACE, while secondary outcomes included cardiac arrest events, all-cause hospitalization, and incidence of myopathy.
Results:
Results: After matching, 6,549 patients were included in each cohort. MACE occurred more frequently in the atorvastatin group (5.7%) compared to the combination therapy group (3.2%), with a hazard ratio of 1.606 (95% CI: 1.302-1.980, P<0.001). Cardiac arrest and all-cause hospitalizations were also higher in the atorvastatin group, with hazard ratios of 1.628 (95% CI: 1.041-2.544, P<0.001) and 1.418 (95% CI: 1.177-1.710, P<0.001), respectively. No significant difference in myopathy was observed (HR 0.915, 95% CI: 0.741-1.129).
Conclusion:
Conclusions: Adding bempedoic acid to atorvastatin therapy appears to confer a protective effect in CAD patients by significantly reducing MACE, cardiac arrest, and hospitalizations without increasing myopathy risk. Prospective studies are warranted to confirm these findings.
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