Combination approach better than statin monotherapy for all-cause mortality at one, three, and five years in acute coronary syndromes<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b><\/p>\n
<\/b><\/p>\n
FRIDAY, Sept. 8, 2023 (HealthDay News) — For patients with acute coronary syndromes (ACS), an upfront combination lipid-lowering therapy is significantly better than statin monotherapy for all-cause mortality, according to a study published online Sept. 6 in the Journal of the American Heart Association<\/em>.<\/p>\n Joanna Lewek, M.D., Ph.D., from the Medical University of Lodz in Poland, and colleagues compared statin monotherapy and upfront combination therapy of statin and ezetimibe in a cohort of 38,023 consecutive patients with ACS who were discharged alive from a national, multicenter prospective observational registry. Two groups were analyzed after propensity score matching: statin monotherapy (atorvastatin or rosuvastatin; 768 patients) and upfront combination therapy of statin and ezetimibe (768 patients).<\/p>\n The researchers found that during follow-up, there was a significant difference in mortality between the groups at one (5.9 versus 3.5 percent), two (7.8 versus 4.3 percent), and three (10.2 versus 5.5 percent) years of follow-up, favoring the upfront combination group; the difference was also significant for the overall period. Compared with atorvastatin, rosuvastatin significantly improved prognosis (odds ratio, 0.790). A significant reduction in all-cause mortality was seen with upfront combination therapy versus statin monotherapy (odds ratio, 0.526), with an absolute risk reduction of 4.7 percent after three years.<\/p>\n “We proved, for the first time, that upfront combination lipid-lowering therapy is superior to statin monotherapy for all-cause mortality,” the authors write. “It undermines the stepwise approach, confirming the benefit of using the upfront combination strategy in patients with very high cardiovascular disease risk.”<\/p>\n Several authors disclosed ties to the pharmaceutical industry.<\/p>\n