Greater reduction seen in LDL-C; reductions also seen in all-cause mortality, major adverse CV events, stroke incidence
By Elana Gotkine HealthDay Reporter
FRIDAY, March 28, 2025 (HealthDay News) — Combination lipid-lowering therapy (LLT) is associated with a greater reduction in low-density lipoprotein cholesterol (LDL-C) compared with statin monotherapy, according to a study published online March 23 in the Mayo Clinic Proceedings.
Maciej Banach, M.D., Ph.D., from the Medical University of Lodz in Poland, and colleagues conducted a systematic literature review of 14 studies (11 randomized controlled trials and three cohort studies) with 108,373 very high-risk patients to examine the efficacy of combination LLT compared to statin monotherapy for LDL-C reduction, associated adverse events, and outcomes.
The researchers found that compared with statin monotherapy, combination LLT significantly more effectively reduced the LDL-C level from baseline in a pooled analysis (mean difference, –12.96 mg/dL) and significantly reduced all-cause mortality, major adverse cardiovascular events, and stroke incidence (odds ratios, 0.81, 0.82, and 0.83, respectively); the effect on cardiovascular mortality was not significant. The groups had a comparable risk for adverse events and therapy discontinuation rates.
“Combination LLT should be considered at the outset of therapy initiation to maximize LDL-C goal attainment and improve reduction in hard cardiovascular disease end points,” the authors write. “These issues should be emphasized more emphatically by guidelines.”
Several authors disclosed ties to the biopharmaceutical industry.
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