Want to Cut Heart Risks? Try This Drug Duo
A comprehensive analysis of over 108,000 patients has revealed that a combined approach using statins and a drug called ezetimibe is more effective in reducing levels of ‘bad’ cholesterol (LDL-C) for patients with blocked arteries than statins alone. This strategy could potentially save thousands of lives each year by preventing heart attacks, strokes, and other cardiovascular diseases.
Key Findings from the Meta-Analysis
The study, published in Mayo Clinic Proceedings, included 14 studies focusing on patients at a high risk of cardiovascular events or those who had already experienced a heart attack or stroke. The combination of ezetimibe with high-dose statins resulted in:
- A 19% reduction in death from any cause.
- A 16% reduction in death from cardiovascular issues.
- An 18% decrease in major cardiovascular events.
- A 17% reduction in stroke incidents.
Additionally, this combined treatment lowered LDL-C levels by an extra 13 mg/dL compared to statins alone, helping more patients achieve the ideal target of less than 70 mg/dL.
The Power of Network Meta-Analysis
The analysis went further by using a network meta-analysis, which allowed for a direct comparison of different treatment methods. This deeper examination showed even more significant benefits:
- 49% reduction in all-cause mortality.
- 39% reduction in major adverse cardiovascular events.
According to Professor Maciej Banach, the study’s lead author, the combined therapy proved both safe and effective. Importantly, the risk of discontinuation due to side effects was significantly lower for patients on moderate-dose statins combined with ezetimibe than those on high-dose statins alone.
A Shift in Treatment Approach
Historically, doctors have been cautious about immediately prescribing combination therapy, preferring to assess the impact of high-dose statins alone. However, this study challenges that approach, advocating for the immediate initiation of combined therapy in high-risk patients.
Professor Peter Toth, a co-author of the study, emphasized that this strategy not only optimizes cholesterol management but could also reduce long-term healthcare costs by decreasing the occurrence of severe cardiovascular complications.
Global Impact of High LDL-C Levels
High LDL-C levels contribute to millions of deaths globally, particularly in Eastern Europe and Central Asia. In 2020 alone, 4.5 million deaths were linked to elevated LDL-C. Implementing combination therapy globally could prevent over 330,000 deaths annually among patients with a history of heart attacks, including almost 50,000 in the U.S. alone.
How the Medications Work
Statins work by limiting the liver’s cholesterol production, while ezetimibe reduces cholesterol absorption from food. Although statins have been effective for many patients, some individuals need additional help to reach safe LDL-C levels, making combination therapy crucial.
Conclusion
This extensive analysis supports a shift towards combined cholesterol-lowering therapy for high-risk patients. By implementing this strategy worldwide, healthcare providers could significantly reduce deaths and complications related to cardiovascular disease.
Source: Inputs from various media Sources
Priya Bairagi
Reviewed by Dr Aarti Nehra (MBBS, MMST)
I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.
