Therapeutic effects of atorvastatin and ezetimibe compared with double-dose atorvastatin in very elderly patients with acute coronary syndrome.
Objective Compared the effect of atorvastatin 10 mg combined ezetimibe 10 mg therapy with atorvastatin 20 mg on the long-term outcomes in very elderly patients with acute coronary syndrome.Methods A total of 230 octogenarian patients with acute coronary syndrome underwent coronary angiography were randomized to combined therapy group (atorvastatin 10 mg/d and ezetimibe 10 mg/d, n=114) or double-dose atorvastatin group (atorvastatin 20mg/d, n=116). The primary end point was one-year incidence of major adverse cardiovascular events (including cardiac death, spontaneous myocardial infarction, unplanned revascularization).Result At the end of one year, the percentage of patients with low-density lipoprotein cholesterol level decreased more than 30% or 50% were comparable between the two groups (93.5% vs. 90.1%, p= 0.36; 54.6% vs. 49.6%, p= 0.45). The rate of major adverse cardiovascular events in combined therapy group was similar with double-dose atorvastatin group (23.2% vs. 19.8%, p=0.55). In COX regression model, the risk of major adverse cardiovascular events in combined group isn't significantly higher than double-dose atorvastatin group (HR [95% CI] 1.12 [0.51 to 2.55], p = 0.74). The patients whose alanine aminotransferase increasing more than upper normal limit in combined group was lower than double-dose atorvastatin group (2.8% vs. 9.0%, p = 0.05).Conclusions For very elderly patients with acute coronary syndrome, atorvastatin combining ezetimibe induced similar long-term outcomes compared with double-dose atorvastatin but with less liver dysfunction.
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Zhi
Z
Liu
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Hengjian
H
Hao
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Chunlin
C
Yin
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Yanyan
Y
Chu
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Jing
J
Li
Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Dong
D
Xu
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000367:Age Factors; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000008:administration & dosage; D000069059:Atorvastatin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D000069438:Ezetimibe / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008297:Male; D011379:Prognosis
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin; D000069438:Ezetimibe
acute coronary syndrome; atorvastatin; elderly; ezetimibe; prognosis