Ezetimibe plus moderate-dose simvastatin after acute coronary syndrome: what are we IMPROVEing on?
The recent IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) is the first study to demonstrate a significant benefit of another medication (ezetimibe) on top of statin therapy in patients who have recently experienced an acute coronary syndrome. Despite the fact that ezetimibe led to positive results on the primary endpoint, the clinical benefit translated to real-life practice is only modest at best. However, this is the first major trial to demonstrate a significant benefit of a lipid medication in addition to statins. We explore the strengths and weaknesses of IMPROVE-IT in the context of current-day acute coronary syndrome practice, where high-dose statins now are prescribed widely.
Saint Luke's Mid America Heart Institute, Kansas City, Mo. Electronic address: jjdinicol@saint-lukes.org.
James J
JJ
DiNicolantonio
R.G. Kar Medical College & Hospital, Kolkata, India.
Subhankar
S
Chatterjee
John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, La.
Carl J
CJ
Lavie
New York University School of Medicine, New York.
Sripal
S
Bangalore
Saint Luke's Mid America Heart Institute, Kansas City, Mo; University of Missouri, Kansas City, Mo.
James H
JH
O'Keefe
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D001384:Azetidines / Q000627:therapeutic use*; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D019821:Simvastatin / Q000627:therapeutic use*; D016896:Treatment Outcome
D001384:Azetidines; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D019821:Simvastatin
Acute coronary syndrome; Ezetimibe; Simvastatin; Statin