Ezetimibe reduces cardiovascular events in diabetics with recent acute coronary syndrome
New data from a clinical trial led by cardiologists at Brigham and Women's Hospital (BWH) and the Duke Clinical Research Institute indicates that the non-statin, cholesterol-lowering drug ezetimibe, when added to a statin in patients admitted to the hospital with an Acute Coronary Syndrome, demonstrated particular benefit in patients with diabetes. Patients with diabetes who did not receive ezetimibe in the study had a nearly 1 in 2 chance of having a major cardiac event or stroke over the next 7 years. Treatment with ezetimibe reduced the relative risk of having another major cardiac or vascular event by 14 percent when compared to patients who did not receive ezetimibe.
These findings were presented as a clinical trial update at the European Society of Cardiology Congress 2015.
"Our study findings represent particularly good news for patients with diabetes who have coronary artery disease," says Robert Giugliano, MD, a senior investigator with the TIMI (Thrombolysis In Myocardial Infarction) Study Group and cardiologist at BWH. "We believe that patients who suffer a heart attack and cannot get to a very low level of LDL-C with a statin should be considered for ezetimibe, particularly if they have diabetes."
In the IMPROVE-IT trial researchers demonstrated that when ezetimibe was added to statin (simvastatin) therapy, patients experienced a further lowering of LDL-cholesterol by 23-24 percent.. Previous trial findings demonstrated that ezetimibe reduced the relative risk of a future major cardiac or vascular event by 6.4 percent compared to placebo, with no increase in adverse safety events.
In this new analysis, researchers used data from the 27 percent of patients in the IMPROVE-IT trial who had diabetes at the start of the study and found that ezetimibe added to simvastatin reduced LDL-cholesterol. According to Dr. Giugliano, "The greater reduction of LDL-cholesterol seen in patients with diabetes who received ezetimibe along with a statin resulted in lower risks of future ischemic stroke, heart attack, and the composite of death due to cardiovascular causes, including heart attack or stroke, when compared to patients with diabetes who received statin therapy alone.
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