Page 10 - Dyslipidaemia_newsletter8_2024_Final

REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #8 2024

The authors conclude that SPC therapy with ROS/EZE offers
CLINICAL PEARLS FROM THE FACULTY a promising strategy for optimising lipid-lowering treatment Dyslipidaemia
outcomes, enhancing patient adherence, and potentially
reducing healthcare costs.

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PROF. SHAWKY DISCUSS THE
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ARTICLE. FOR THE LINK TO FULL ARTICLE

Combination of low- or moderate-intensity statin and ezetimibe vs. high-intensity
statin monotherapy on primary prevention of cardiovascular disease and all-

cause death: a propensity-matched nationwide cohort study.
Jun JE, et al. Eur J Prev Cardiol. 2024 Aug 9;31(10):1205-1213.

While guidelines recommend high-intensity statins for individuals at high CVD risk, these may be associated with a higher incidence
of adverse events. Statins remain the cornerstone of lipid-lowering therapy but ezetimibe, which inhibits cholesterol absorption,
can effectively complement statins in lowering LDL-C and reducing CVD risk. There is a growing body of evidence that combining
moderate-intensity statins with ezetimibe can improve cardiovascular outcomes with better tolerability.

Utilising a large, nationwide database in Korea, the authors employed a propensity score matching methods to examine two cohorts
comparing high-intensity statin monotherapy with low-or moderate-
intensity statin and ezetimibe combinations. Primary outcome was a
composite of myocardial infarction (MI), stroke, and all-cause death.

The combination of moderate-intensity statin with ezetimibe
significantly reduced the risk of the composite outcome (hazard
ratio [HR] 0.84, 95% confidence interval [CI] 0.77–0.92, P < 0.001)
compared to high-intensity statin monotherapy. The combinations
also significantly reduced the individual risks of MI (HR 0.81, 95%
CI 0.71–0.94, P = 0.005) and stroke (HR 0.78, 95% CI 0.65–0.93,
P = 0.005) compared to high-intensity statin alone. There was no
statistically significant difference in all-cause death between the two
groups.

The combination of low-intensity statin with ezetimibe also showed
a significant reduction in the risk of the composite outcome (HR
0.80, 95% CI 0.66–0.97, P = 0.024) compared to high-intensity
statin monotherapy. However, there were no statistically significant
differences in the risks of MI, stroke, or all-cause death when
considered individually.

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