Ezetimibe plus moderate-dose simvastatin after acute coronary syndrome: what are we IMPROVEing on?

The American Journal of Medicine
James J DiNicolantonioJames H O'Keefe

Abstract

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.

References

Apr 13, 2001·JAMA : the Journal of the American Medical Association·G G SchwartzUNKNOWN Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators
Mar 10, 2004·The New England Journal of Medicine·Christopher P CannonUNKNOWN Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators
Mar 20, 2010·JACC. Cardiovascular Interventions·Carl J Lavie, Richard V Milani
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Sep 4, 2012·BMC Cardiovascular Disorders·Jinwei TianBo Yu
Apr 2, 2013·Journal of the American College of Cardiology·Carl J LavieJames H O'Keefe
Jul 30, 2014·JAMA Internal Medicine·Joseph S RossHarlan M Krumholz

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Citations

Jan 1, 2016·Trends in Pharmacological Sciences·Sivaram Pillarisetti
Sep 27, 2015·Clinical Chemistry·Xuemei ZhaoOmar F Laterza
May 25, 2016·Current Opinion in Cardiology·Maciej BanachPeter P Toth

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