SynthesisClinical cardiology2024
Safety and Effectiveness of High-Intensity Statins Versus Low/Moderate-Intensity Statins Plus Ezetimibe in Patients With Atherosclerotic Cardiovascular Disease for Reaching LDL-C Goals: A Systematic Review and Meta-Analysis.
Synthesis in Clinical cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of atorvastatin on inflammatory markers, lipid profile, liver enzymes, and pulmonary function in patients with lung diseases: a systematic review and meta-analysis of randomized controlled trials.European journal of medical research · 2026Pooled it
- Cardiovascular outcomes and adverse drug reactions associated with the use of ezetimibe in combination with a statin in diabetes mellitus patients with higher risk for myocardial infarction: a meta-analysis.BMC cardiovascular disorders · 2026 · on this mapPooled it
- Suboptimal lipid management is associated with subclinical left ventricular dysfunction in type 2 diabetes mellitus patients with preserved ejection fraction: a cardiac magnetic resonance feature-tracking study.BMC cardiovascular disorders · 2026Article
- Patients with type 1 diabetes mellitus and recommended low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B targets - a SwissDiab study.Frontiers in endocrinology · 2026Article
- Association Between Statin Use and Glaucoma Risk: A Population-Based Study.Investigative ophthalmology & visual science · 2025Article
- Small dense LDL: An underestimated driver of atherosclerosis (Review).Molecular medicine reports · 2025Review
- Effectiveness and Safety of Very-Low-Dose Rosuvastatin-Ezetimibe Therapy in Korean Patients with Dyslipidaemia: A Multicentre Prospective Observational Study.Clinical drug investigation · 2025Observational
- Atherosclerosis-induced arterial erectile dysfunction: pathogenesis, diagnosis, and therapeutic strategies.Translational andrology and urology · 2025Review
- Low-Density Lipoprotein Cholesterol Target Attainment in Lithuania: A Nationwide Analysis of Real-World Health Data.Medicina (Kaunas, Lithuania) · 2025Article
- A Comprehensive Review of the Latest Approaches to Managing Hypercholesterolemia: A Comparative Analysis of Conventional and Novel Treatments: Part I.Life (Basel, Switzerland) · 2025Review
- Article
- Rosuvastatin-based combination treatment with acetylsalicylic acid or ezetimibe in the management of patients at high and very high cardiovascular risk. Expert opinion paper of the Polish Lipid Association 2025.Archives of medical science : AMS · 2025Article
- Mechanism-guided pharmacotherapy for cardiometabolic multimorbidity: from pathophysiology to phenotype-prioritized treatment.Frontiers in endocrinology · 2025Review
- Treatment of dyslipidemia in Poland - common diagnostics, early combined therapy. Expert position statement endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy. 5th Declaration of Sopot.Cardiology journal · 2025Article
- Comparative Pharmacokinetics of Five Major Ingredients in Normal and Atherosclerotic Rats after Oral Administration of Shenlian Formula.Current drug metabolism · 2025Article
- Advancements in the Treatment of Atherosclerosis: From Conventional Therapies to Cutting-Edge Innovations.ACS pharmacology & translational science · 2024Review
- Efficacy and diabetes risk of moderate-intensity statin plus ezetimibe versus high-intensity statin after percutaneous coronary intervention.Cardiovascular diabetology · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundIt remains controversial whether adding ezetimibe to low/moderate-intensity statins has a more beneficial impact on the treatment efficacy and safety of patients with existing atherosclerotic cardiovascular disease (ASCVD) compared to high-intensity statin regimens. HYPOTHESIS: A combination of low/moderate-intensity statins plus ezetimibe might be more effective and safer than high-intensity statin monotherapy.
methodsWe searched databases for randomized controlled trials comparing lipid profile alterations, drug-related adverse events, and MACE components between high-intensity statin monotherapy and low/moderate-intensity statin plus ezetimibe combination therapy. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) were estimated using a random-effects model.
resultsOur comprehensive search resulted in 32 studies comprising 6162 patients treated with monotherapy against 5880 patients on combination therapy. Combination therapy was more effective in reducing low-density lipoprotein cholesterol (LDL-C) levels compared to monotherapy (MD = -6.6, 95% CI: -10.6 to -2.5); however, no significant differences were observed in other lipid parameters. Furthermore, the combination therapy group experienced a lower risk of myalgia (RR = 0.27, 95% CI: 0.13-0.57) and discontinuation due to adverse events (RR = 0.61, 95% CI: 0.51-0.74). The occurrence of MACE was similar between the two treatment groups.
conclusionsAdding ezetimibe to low/moderate-intensity statins resulted in a greater reduction in LDL-C levels, a lower rate of myalgia, and less drug discontinuation compared to high-intensity statin monotherapy in patients with existing cardiovascular disease. However, according to our meta-analysis, the observed reduction in LDL-C levels in the combination group did not correlate with a reduction in MACE compared to the high-intensity statin group.
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Registered trials
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.