Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in patients with acute myocardial infarction propensity-score matching analysis

Mi Seon Ji, Myung Ho Jeong, Young keun Ahn, Sang Hyung Kim, Young Jo Kim, Shung Chull Chae, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Chong Jin Kim, Myeong Chan Cho, Seung-Woon Rha, Jang Ho Bae, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background It is unclear whether simvastatin–ezetimibe could be an alternative therapy to high-intensity statin therapy in high-risk patients. The aim of this study was to compare the clinical outcomes of simvastatin–ezetimibe and high-intensity statin therapy in patients with acute myocardial infarction (AMI), and especially in those with high-risk factor. Methods A total of 3520 AMI patients in the KAMIR (Korea Acute Myocardial Infarction Registry) were classified into simvastatin–ezetimibe group (n = 1249) and high-intensity statin group (n = 2271). Multivariate analysis and propensity-score matching analysis were performed. The primary endpoint was major adverse cardiac events (MACE) at 12-months follow-up. Results In overall AMI patients, MACE occurred in 116 patients (9.3%) in simvastatin–ezetimibe group and 116 patients (5.1%) in high-intensity statin group. The difference in MACE between groups was driven by repeat revascularization (5.9% vs. 2.2%). After propensity matching analysis, simvastatin–ezetimibe was associated with a higher incidence of MACE than high-intensity statin therapy (adjusted hazard ratio: 3.090, 95% confidence interval: 1.715 to 5.566, p < 0.001). However, in patients with high-risk factors, such as diabetes, old age, or heart failure, simvastatin-ezetimibe had similar incidence of MACE compared with high-intensity statin therapy in further adjusted analysis. Conclusions In overall AMI patients, high-intensity statin therapy had better clinical outcomes than simvastatin–ezetimibe. However, in patients with high-risk factor, simvastatin–ezetimibe had comparable clinical outcomes to high-intensity statin therapy. Therefore, simvastatin–ezetimibe could be used as an alternative to high-intensity statin therapy in such patients.

Original languageEnglish
Pages (from-to)50-59
Number of pages10
JournalInternational Journal of Cardiology
Volume225
DOIs
Publication statusPublished - 2016 Dec 15

Keywords

  • Ezetimibe simvastatin combination
  • Myocardial infarction
  • Statins

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in patients with acute myocardial infarction propensity-score matching analysis'. Together they form a unique fingerprint.

  • Cite this

    Ji, M. S., Jeong, M. H., Ahn, Y. K., Kim, S. H., Kim, Y. J., Chae, S. C., Hong, T. J., Seong, I. W., Chae, J. K., Kim, C. J., Cho, M. C., Rha, S-W., Bae, J. H., Seung, K. B., & Park, S. J. (2016). Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in patients with acute myocardial infarction propensity-score matching analysis. International Journal of Cardiology, 225, 50-59. https://doi.org/10.1016/j.ijcard.2016.09.082