The number of patients suffering from severe diseases such as myocardial infarction and cerebral infarction is increasing as we enter the super-aged society and expand the westernized diet. While the rate of atherosclerosis is gradually increasing, domestic researchers have confirmed that ezetimibe combination therapy is effective for control of LDL cholesterol in the high risk group for atherosclerosis.
Severance Hospital Professor of Cardiology Kim Joon Sung and Lee Seung Joon and a research team of Korea University Anam Hospital Cardiology Professor Hong Sun Joon and Cha Jeong Joon found that moderate combined treatment with statins and ezetimibe was effective in controlling LDL cholesterol compared to conventional high-dose monotherapy with statins in the group of ultra-high risk for atherosclerosis On the 3rd day, high compliance with continuous use of the drug was revealed.
The results of this study were published in the international journal Journal of the American Medical Association of Cardiology (JAMA Cardiology, IF 24.0).
For the ultra-high risk group for developing atherosclerosis, it is important to keep LDL cholesterol levels low (below 55 mg/dL or 70 mg/dL) to prevent recurrence of myocardial infarction or stroke and death from cardiogenic causes. The most commonly used drugs to lower LDL cholesterol are statins, which inhibit the synthesis of LDL cholesterol in the liver.
However, if high-dose statin treatment is continued, there is a high risk of side effects such as muscle damage, decreased liver function, and increased blood sugar, making long-term use difficult.
The research team sub-analyzed an existing study based on patient risk assessment (proving superior LDL-cholesterol control with moderate combination therapy with statins and ezetimibe compared with high-intensity statin monotherapy) published by a research team in the Department of Cardiology. Severance Hospital in The Lancet international magazine.
The study group compared and analyzed the treatment effects of high-intensity statin monotherapy and moderate-intensity statin/ezetimibe combination therapy in 1511 patients at high risk of atherosclerosis. The high-risk group for atherosclerosis was identified by patients with 12 diseases, including a history of myocardial infarction, concomitant peripheral arterial diseases, and arterial hypertension.
The research team randomly assigned two treatment regimens and followed them for 3 years to analyze mean LDL cholesterol levels, incidence of complications such as heart attack, myocardial infarction and cerebral infarction, and patient compliance with continuous medication.
↑ As a result of the analysis of the mean LDL-cholesterol level during the observation period of the two groups, the combination therapy group showed an excellent LDL-cholesterol-lowering effect: 57 mg/dL in the combination therapy group and 65 mg/dL in the monotherapy group (left graph).
The rate of drug discontinuation due to drug withdrawal was 4.6% in the combination therapy group, which is lower than 7.7% in the monotherapy group, confirming the benefit of continuous medication (right graph).
As a result of the analysis of mean LDL cholesterol levels during the observation period in the two groups, the combination therapy group showed an excellent LDL-cholesterol lowering effect: 57 mg/dl in the combination therapy group and 65 mg/dl in the monotherapy group. With regard to the incidence of complications such as heart attack, myocardial infarction and cerebral infarction, during the clinical observation period, the combination therapy group was 11.2%, which did not differ from the monotherapy group (11.7%).
In addition, the discontinuation rate due to drug withdrawal was 4.6% in the combination therapy group, which was lower than 7.7% in the monotherapy group, confirming the benefit of continuous medication.
Professor Kim Jung-sung said: “In patients with atherosclerosis, a high-risk group with a high risk of vascular occlusive disease, moderate statin/ezetimibe combination therapy effectively controls LDL cholesterol compared to high-intensity statin monotherapy, and also reduces the risk of drug withdrawal and complications. due to side effects. “We expect to be able to provide better treatment for patients with atherosclerosis in the ultra-high risk group,” he said. Correspondent Kang Kyung Nam