Impact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis

Mahajan, Kunal; Nagendra, Lakshmi; Dhall, Anil; Dutta, Deep

doi:10.1016/j.ejim.2024.02.004

European Journal of Internal Medicine

2024

DOI: 10.1016/j.ejim.2024.02.004

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Impact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis

Kunal Mahajan,

Lakshmi Nagendra,

Anil Dhall

et al.

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2024

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Cited by 2 publications

References 33 publications

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Are We Using Ezetimibe As Much As We Should?

Manolis,

Mikhailidis

et al. 2024

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Lipid-lowering therapies, particularly non-statin regimens, are underutilized as ~2/3 of patients with atherosclerotic cardiovascular (CV) disease (CVD) are not optimally managed, and do not attain target low-density lipoprotein cholesterol (LDL-C) concentrations, despite statin treatment. Statins have been the mainstay of hypolipidemic therapies; however, they are plagued by adverse effects, which have partly hindered their more widespread use. Ezetimibe is often the first added mode of treatment to attain LDL-C goals as it is efficacious and also allows the use of a smaller dose of statin, while the need for more expensive therapies is obviated. We herein provide a comprehensive review of the effects of ezetimibe in lipid lowering and reducing CV events and improving outcomes. Of the hypolipidemic therapies, oral ezetimibe, in contrast to newer agents, is the most convenient and/or affordable regimen to be utilized as mono- or combined therapy supported by data from CV outcomes studies attesting to its efficacy in reducing CVD risk and events. When combined with a statin, the statin dose could be lower, thus curtailing side-effects, while the hypolipidemic effect is enhanced (by ~20%) as the percentage of patients with target level LDL-C (<70 mg/dL) is higher with combined treatment versus a high-intensity statin. Ezetimibe could also serve as an alternative treatment in cases of statin intolerance. In conclusion, ezetimibe has an excellent safety/tolerability profile; it is the first added treatment to a statin that can attain LDL-C targets. In the combined therapy, the hypolipidemic effect is enhanced while the dose of statin could be lower, thus limiting the occurrence of side-effects. Ezetimibe could also serve as an alternative mode of treatment in cases of statin intolerance.

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Are We Using Ezetimibe As Much As We Should?

Manolis,

Mikhailidis

et al. 2024

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Commencement of Atorvastatin and Ezetimibe Immediately in Patients Presenting with Acute Coronary Syndrome

Sallam,

Hassan,

Connolly

et al. 2024

Eur Cardiol

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Lipids are implicated in the development of coronary atherosclerosis. Achieving a significant reduction in lipid levels remains a crucial aspect of secondary prevention following an acute coronary syndrome event. Novel lipid-lowering therapies now provide clinicians with a variety of therapeutic strategies to choose from and tailor to individual patient needs. This review focuses on evidence supporting the importance of early and intensive lipid-lowering therapy use in patients presenting with acute coronary syndrome, specifically addressing data relating to atorvastatin and ezetimibe use in this high-risk cohort of patients.

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Impact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis

Cited by 2 publications

References 33 publications

Are We Using Ezetimibe As Much As We Should?

Are We Using Ezetimibe As Much As We Should?

Commencement of Atorvastatin and Ezetimibe Immediately in Patients Presenting with Acute Coronary Syndrome

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