Starting cholesterol treatment with a statin alone or a statin plus ezetimibe produced similar cardiovascular-event rates in an Ez-PAVE analysis released November 7 by the American Heart Association.
The randomized comparison involved 3,048 adults with atherosclerotic cardiovascular disease at 17 South Korean hospitals. Participants were separately assigned an LDL-cholesterol goal, and medications could change during follow-up to reach it.
Over three years, the combined outcome of cardiovascular death, heart attack, stroke, artery-opening procedures or hospitalization for unstable angina occurred in 8.5% starting combination treatment and 7.9% starting a statin alone. The difference was not statistically significant.
This was a comparison of starting strategies, rather than permanently fixed drug regimens. Substantial numbers starting a statin alone later received ezetimibe under the protocol.
Safety outcomes were similar. The study may have been too small or too short to detect modest differences, was open-label, and included predominantly men in South Korea, limiting generalizability. The association said the analysis was simultaneously published in Circulation.