Evidence mapPaperPMID 38578578Full record

SynthesisAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2024

Comparative Safety and Efficacy of Low/Moderate-Intensity Statin plus Ezetimibe Combination Therapy vs. High-Intensity Statin Monotherapy in Patients with Atherosclerotic Cardiovascular Disease: An Updated Meta-Analysis.

Ishaque Hameed, Syeda Ayesha Shah, Ashnah Aijaz, Hasan Mushahid, Syed Husain Farhan, Muhammad Dada, Adam Bilal Khan, Reeha Amjad, Fawad Alvi, Mustafa Murtaza and 2 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Article
  5. Therapeutic Management of LDL-C: Efficacy and Economic Impact Assessment.Journal of cardiovascular development and disease · 2025
    Review
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Ishaque HameedDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Syeda Ayesha ShahDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ashnah AijazDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Hasan MushahidDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan. Hasamushahid@gmail.com.ORCID http://orcid.org/0000-0002-3899-2098
Syed Husain FarhanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Muhammad DadaDepartment of Medicine, Ziauddin University, Karachi, Pakistan.
Adam Bilal KhanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Reeha AmjadDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Fawad AlviDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Mustafa MurtazaDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Zaid ZuberiDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Mohammad HamzaDepartment of Internal Medicine, Albany Medical Center, Albany, USA.
Dow University of Health Sciences · PKAlbany Medical Center Hospital · USZiauddin University · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimStatin therapy is considered the gold standard for treating hypercholesterolemia. This updated meta-analysis aims to compare the efficacy and safety of a low/moderate-intensity statin in combination with ezetimibe compared with high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (ASCVD).

methodsA systematic search of two databases (PubMed and Cochrane CENTRAL) was conducted from inception to January 2023 and a total of 21 randomized clinical trials (RCTs) were identified and included in the analysis. Data were pooled using Hedges's g and a Mantel-Haenszel random-effects model to derive standard mean differences (SMDs) and 95% confidence intervals (Cis). The primary outcome studied was the effect of these treatments on lipid parameters and safety events.

resultsThe results revealed that combination therapy was more effective in reducing low-density lipoprotein cholesterol (LDL-C) levels (SMD= - 0.41; CI - 0.63 to - 0.19; P = 0.0002). There was no significant change in the levels of high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), Apo A1, or Apo B. The safety of these treatments was assessed by the following markers alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatine phosphokinase (CK), and a significant difference was only observed in CK (SMD: - 0.81; CI - 1.52 to - 0.10; P = 0.02).

conclusionThis meta-analysis demonstrated that the use of low/moderate-intensity statin combination therapy significantly reduced LDL-C levels compared with high-intensity statin monotherapy, making it preferable for patients with related risks. However, further trials are encouraged to evaluate potential adverse effects associated with combined therapy.

Indexed as

Anticholesteremic AgentsAtherosclerosisDrug Therapy, CombinationEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsCardiovascular DiseasesCholesterol, HDLCholesterol, LDLHumansHypercholesterolemiaRandomized Controlled Trials as TopicAnticholesteremic AgentsCholesterol, HDLCholesterol, LDLEzetimibeHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID38578578
OpenAlexW4393987562

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.