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Nov 20, 2014

New Drug Combination Improves Outcomes for Patients at High Risk for Heart Attack, Stroke

Adding the non-statin agent, ezetimibe, to traditional cholesterol-lowering therapy reduces risk in patients with acute coronary syndrome.

Adding the non-statin agent, ezetimibe (brand: Zetia), to traditional cholesterol-lowering therapy reduces risk of heart events in high-risk patients with a history of heart attack or unstable angina, according to a study presented on Nov. 17 at the American Heart Association 2014 Scientific Session. 

Known as the IMPROVE-IT trial, this study tested a new drug combination in patients with acute coronary syndrome—an umbrella term for conditions, such as heart attack, where blood supply to the heart is blocked. Since patients with acute coronary syndrome are at high risk for future heart events, cholesterol-lowering statins are often the best option to reduce cholesterol and risk of complications. But findings from the IMPROVE-IT trial suggest combining traditional statins with the non-statin, ezetimibe, may help further reduce risk of heart attack and stroke in high-risk patients. 

Led by researchers at Brigham and Women’s Hospital, this study included more than 18,000 patients with acute coronary syndrome who were taking statins and at high-risk for heart events. Participants were randomly assigned to take ezetimibe plus a statin (simvastatin (brand: Zocor)) or the statin alone, and researchers followed participants for an average of six years to compare the efficacy of each treatment. 

Results showed that compared to patients taking the statin alone, patients taking simvastatin plus ezetimibe had 6.4% lower combined risk of complications like heart attack, stroke and heart-related death.  

As authors explain, this is the first trial to show that combining a non-statin medication with a statin helps reduce risk of heart events—an important finding that has the potential to save many lives. Based on study analysis, researchers estimate that treating 100 patients with this new combination would help prevent two life-threatening heart events. Of course, results of the IMPROVE-IT trial have yet to be published but findings are encouraging and will likely spark future research regarding this novel drug combination to treat acute coronary syndrome.

Questions for You to Consider

  • What is acute coronary syndrome?
  • Acute coronary syndrome is an umbrella term used to describe situations where there is sudden, reduced blood flow to the heart. Acute coronary syndrome encompasses chest pain and heart attack, both of which can be serious and life-threatening.
  • How is acute coronary syndrome treated?

  • Acute coronary syndrome can be treated with a variety of medications and/or procedures, depending on how blocked the arteries are. Medications can include any combination of aspirin, thrombolytics, beta blockers, cholesterol-lowering drugs and ACE inhibitors, among others. Procedures can also help treat acute coronary syndrome, including angioplasty, stenting and coronary bypass surgery.


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