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

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Ezetimibe simvastatin combination

Myocardial infarction

Statins

Journal Title international journal of cardiology
Publication Year Start




PMID- 27710803
OWN - NLM
STAT- In-Process
DA  - 20161006
LR  - 20170208
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 225
DP  - 2016 Dec 15
TI  - Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in
      patients with acute myocardial infarction propensity-score matching analysis.
PG  - 50-59
LID - S0167-5273(16)32508-6 [pii]
LID - 10.1016/j.ijcard.2016.09.082 [doi]
AB  - 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.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Ji, Mi Seon
AU  - Ji MS
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Jeong, Myung Ho
AU  - Jeong MH
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic
      address: [email protected]
FAU - Ahn, Young Keun
AU  - Ahn YK
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Kim, Sang Hyung
AU  - Kim SH
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Kim, Young Jo
AU  - Kim YJ
AD  - Yeungnam Univ. Hosp., Daegu, Republic of Korea.
FAU - Chae, Shung Chull
AU  - Chae SC
AD  - Kyungpuk National Univ. Hosp., Daegu, Republic of Korea.
FAU - Hong, Taek Jong
AU  - Hong TJ
AD  - Busan National Univ. Hosp., Busan, Republic of Korea.
FAU - Seong, In Whan
AU  - Seong IW
AD  - Chungnam National Univ. Hosp., Daejon, Republic of Korea.
FAU - Chae, Jei Keon
AU  - Chae JK
AD  - Chunbuk National Univ. Hosp., Jeonju, Republic of Korea.
FAU - Kim, Chong Jin
AU  - Kim CJ
AD  - KyungHee Univ. Hosp., Seoul, Republic of Korea.
FAU - Cho, Myeong Chan
AU  - Cho MC
AD  - Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Rha, Seung-Woon
AU  - Rha SW
AD  - Korea University Guro Hospital, Seoul, Republic of Korea.
FAU - Bae, Jang Ho
AU  - Bae JH
AD  - Konyang University, Daejon, Republic of Korea.
FAU - Seung, Ki Bae
AU  - Seung KB
AD  - Catholic Univ. Hosp., Seoul, Republic of Korea.
FAU - Park, Seung Jung
AU  - Park SJ
AD  - Asan Medical Center, Seoul, Republic of Korea.
CN  - other Korea Acute Myocardial Infarction Registry Investigators
LA  - eng
PT  - Journal Article
DEP - 20160928
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
OTO - NOTNLM
OT  - Ezetimibe simvastatin combination
OT  - Myocardial infarction
OT  - Statins
EDAT- 2016/10/07 06:00
MHDA- 2016/10/07 06:00
CRDT- 2016/10/07 06:00
PHST- 2016/06/27 [received]
PHST- 2016/09/22 [revised]
PHST- 2016/09/23 [accepted]
AID - S0167-5273(16)32508-6 [pii]
AID - 10.1016/j.ijcard.2016.09.082 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Dec 15;225:50-59. doi: 10.1016/j.ijcard.2016.09.082. Epub
      2016 Sep 28.

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