Comparison of Statin With Ezetimibe Combination Therapy Versus Statin Monotherapy for Primary Prevention in Middle-Aged Adults
- Author:
Jung-Joon CHA
1
;
Soon Jun HONG
;
Subin LIM
;
Ju Hyeon KIM
;
Hyung Joon JOO
;
Jae Hyoung PARK
;
Cheol Woong YU
;
Do-Sun LIM
;
Jang Young KIM
;
Jin-Ok JEONG
;
Jeong-Hun SHIN
;
Chi Young SHIM
;
Jong-Young LEE
;
Young-Hyo LIM
;
Sung Ha PARK
;
Eun Joo CHO
;
Hasung KIM
;
Jungkuk LEE
;
Ki-Chul SUNG
;
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2024;54(9):534-544
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Lipid lowering therapy is essential to reduce the risk of major cardiovascular events; however, limited evidence exists regarding the use of statin with ezetimibe as primary prevention strategy for middle-aged adults. We aimed to investigate the impact of single pill combination therapy on clinical outcomes in relatively healthy middleaged patients when compared with statin monotherapy.
Methods:Using the Korean National Health Insurance Service database, a propensity score match analysis was performed for baseline characteristics of 92,156 patients categorized into combination therapy (n=46,078) and statin monotherapy (n=46,078) groups. Primary outcome was composite outcomes, including death, coronary artery disease, and ischemic stroke. And secondary outcome was all-cause death. The mean follow-up duration was 2.9±0.3 years.
Results:The 3-year composite outcomes of all-cause death, coronary artery disease, and ischemic stroke demonstrated no significant difference between the 2 groups (10.3% vs.10.1%; hazard ratio [HR], 1.022; 95% confidence interval [CI], 0.980–1.064; p=0.309).Meanwhile, the 3-year all-cause death rate was lower in the combination therapy group than in the statin monotherapy group (0.2% vs. 0.4%; p<0.001), with a significant HR of 0.595 (95% CI, 0.460–0.769; p<0.001). Single pill combination therapy exhibited consistently lower mortality rates across various subgroups.
Conclusions:Compared to the statin monotherapy, the combination therapy for primary prevention showed no difference in composite outcomes but may reduce mortality risk in relatively healthy middle-aged patients. However, since the study was observational, further randomized clinical trials are needed to confirm these findings.
