Evidence mapPaperPMID 42296115Full record

SynthesisClinical cardiology2026

Moderate Intensity Statins Plus Ezetimibe Combination Therapy Versus High Intensity Statins Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

Emad Uddin Sajid, Muhammad Hasnain Azeem, Alishba Fatima, Syeda Masooma Jafri, Danish Hassan, Taha Ibrahim, Kashish Zehra Manjee, Syed Rayyan Ahmed, Tooba Ali, Rida Shakeel and 3 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Emad Uddin SajidDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0004-1365-7906
Muhammad Hasnain AzeemDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0004-5643-0744
Alishba FatimaDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0001-1802-0259
Syeda Masooma JafriDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0007-6601-0833
Danish HassanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0000-7126-4618
Taha IbrahimDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0002-6970-8261
Kashish Zehra ManjeeDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0009-7345-9633
Syed Rayyan AhmedDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0000-0003-2285-5053
Tooba AliDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0000-0003-1867-943X
Rida ShakeelDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0004-3515-4859
Muhammad UsmanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0004-5650-2875
Raghabendra Kumar MahatoGandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal.ORCID https://orcid.org/0009-0009-9434-1650
Danish BawaMidwest Heart and Vascular Specialist, HCA Midwest, Overland Park, Kansas, USA.ORCID https://orcid.org/0000-0002-8753-822X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-intensity statins are standard therapy after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), yet tolerability concerns and residual cardiovascular risk remain important challenges. Moderate-intensity statin therapy combined with ezetimibe has emerged as a potential alternative, although its comparative effectiveness after PCI remains uncertain.

methodsWe performed a systematic review and meta-analysis according to PRISMA guidelines. PubMed, Cochrane Library, and ClinicalTrials.gov were searched through September 2025 for studies enrolling adults undergoing PCI and comparing moderate-intensity statin plus ezetimibe therapy with high-intensity statin therapy. The primary outcome was major adverse cardiovascular events (MACE), defined as all-cause mortality, myocardial infarction (MI), stroke, and revascularization. Secondary outcomes included individual cardiovascular endpoints and safety outcomes such as new-onset diabetes and rhabdomyolysis. Random-effects models were used to calculate pooled risk ratios (RRs).

resultsNine studies involving 179 621 patients were included, the majority being observational studies. No significant difference was observed in MACE between treatment strategies (RR 0.96, 95% CI 0.81-1.12). Modest reductions were observed in cardiovascular mortality (RR 0.83, 95% CI 0.71-0.98) and MI (RR 0.74, 95% CI 0.58-0.95), although findings were non-robust with wide prediction intervals. Revascularization rates were similar between groups. Subgroup analyses suggested lower heterogeneity in intermediate follow-up and non-ACS populations.

conclusionsModerate-intensity statin plus ezetimibe therapy may provide cardiovascular outcomes comparable to high-intensity statins after PCI. However, persistent heterogeneity limits certainty, and large randomized trials are needed to confirm long-term efficacy and safety.

Indexed as

Acute Coronary SyndromeAnticholesteremic AgentsEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsPercutaneous Coronary InterventionDrug Therapy, CombinationHumansTreatment OutcomeAnticholesteremic AgentsEzetimibeHydroxymethylglutaryl-CoA Reductase Inhibitorsacute coronary syndromeezetimibeMACEmyocardial infarctionPCIstatins

Identifiers

PMID42296115
PMCPMC13267995

What Socratic holds

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LicenceCC BY
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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.