Until the results of several statin trials are available, it is recommended that the current indications and usage of ezetimibe be continued
Patients receiving statin therapy to reduce total and low-density lipoprotein cholesterol (LDL-C) levels still have a residual risk of cardiovascular (CV) events. In most statin trials, CV events are reduced by about 30% compared with placebo, leaving about 70% residual risk of CV events that occur in spite of statin therapy. Factors that may contribute to residual risk are listed in Box 1.
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- 1. Barter P, Gotto AM, La Rosa JC, et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med 2007; 357: 1301-1310.
- 2. Taylor AJ, Villines TC, Stanek EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 2009; 361: 2113-2122.
- 3. Kastelein JJ, Bots ML. Statin therapy with ezetimibe or niacin in high-risk patients. N Engl J Med 2009; 361: 2180-2183.
- 4. Blumenthal RS, Michos ED. The HALTS trials — halting atherosclerosis or halted too early? N Engl J Med 2009; 361: 2178-2180.
- 5. Sorrentino SA, Besler C, Rohrer L, et al. Endothelial-vasoprotective effects of high-density lipoprotein are impaired in patients with type 2 diabetes mellitus but are improved after extended-release niacin therapy. Circulation 2009; 121:110-122.
- 6. Hodis HN, Mack WJ, LaBree L, et al. The role of carotid intima-media thickness in predicting clinical coronary events. Ann Intern Med 1998; 128: 262-269.
- 7. Matthan NR, Giovanni A, Schaefer EJ, et al. Impact of simvastatin, niacin, and/or antioxidants on cholesterol metabolism in CAD patients with low HDL. J Lipid Res 2003; 44: 800-806.
- 8. Taylor AJ, Lee HJ, Sullenberger LE. The effect of 24 months of combination statin and extended-release niacin on carotid intima-media thickness: ARBITER 3. Curr Med Res Opin 2006; 22: 2243-2250.
Ian Hamilton-Craig has received financial support to attend and give presentations at scientific meetings from AstraZeneca, Merck Sharp & Dohme, Schering-Plough, Pfizer, Bristol-Myers Squibb, Solvay, Sanofi-Aventis, Novartis and Abbott Australasia. He is a member of the Lipid Advisory Board of Merck Sharp & Dohme/Schering-Plough, AstraZeneca and Solvay, the Familial Hypercholesterolaemia Committee of the Australian Atherosclerosis Society, and the Council on Genetic Cardiovascular Diseases of the Cardiac Society of Australia and New Zealand.