Ezetimibe added to statin therapy after acute coronary syndromes

Christopher P. Cannon, Michael A. Blazing, Robert P. Giugliano, Amy McCagg, Jennifer A. White, Pierre Theroux, Harald Darius, Basil S. Lewis, Ton Oude Ophuis, J. Wouter Jukema, Gaetano M. De Ferrari, Witold Ruzyllo, Paul De Lucca, KyungAh Im, Erin A. Bohula, Craig Reist, Stephen D. Wiviott, Andrew M. Tershakovec, Thomas A. Musliner, Eugene BraunwaldRobert M. Califf

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (≥30 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P

Original languageEnglish
Pages (from-to)2387-2397
Number of pages11
JournalNew England Journal of Medicine
Issue number25
Publication statusPublished - Jun 18 2015

ASJC Scopus subject areas

  • Medicine(all)

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