دورية أكاديمية
Impact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis.
| العنوان: | Impact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis. |
|---|---|
| المؤلفون: | Mahajan K; Department of Cardiology, Himachal Heart Institute, Mandi, Himachal Pradesh, India. Electronic address: Kunalmahajan442@gmail.com., Nagendra L; Department of Endocrinology, JSS Academy of Higher Education and Research, Mysore, India. Electronic address: drlakshminagendra@jssuni.edu.in., Dhall A; Department of Cardiology, Janakpuri Superspeciality Hospital, New Delhi, India., Dutta D; Department of Endocrinology, Center for Endocrinology Diabetes Arthritis & Rheumatism (CEDAR) Superspeciality Healthcare, Dwarka, New Delhi, India. Electronic address: deepdutta2000@yahoo.com. |
| المصدر: | European journal of internal medicine [Eur J Intern Med] 2024 Jun; Vol. 124, pp. 99-107. Date of Electronic Publication: 2024 Feb 09. |
| نوع المنشور: | Journal Article; Systematic Review; Meta-Analysis |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 9003220 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0828 (Electronic) Linking ISSN: 09536205 NLM ISO Abbreviation: Eur J Intern Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1999- : Amsterdam, The Netherlands : Elsevier Science Original Publication: Basingstoke, Hampshire, UK : Published by the Macmillan Press on behalf of the European Association of Internal Medicine, c1989- |
| مواضيع طبية MeSH: | Acute Coronary Syndrome*/drug therapy , Acute Coronary Syndrome*/blood , Ezetimibe*/therapeutic use , Anticholesteremic Agents*/therapeutic use , Anticholesteremic Agents*/administration & dosage , Cholesterol, LDL*/blood, Humans ; Randomized Controlled Trials as Topic ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Drug Therapy, Combination ; Treatment Outcome |
| مستخلص: | Objective: Scant data is available on the efficacy and safety of adding ezetimibe to high-intensity statin therapy for early and rapid reduction of low-density lipoprotein cholesterol (LDL-C) within 4-12 weeks of an acute-event in acute coronary syndrome (ACS). We undertook this meta-analysis to address this knowledge-gap. Methods: Electronic databases were searched for RCTs involving patients with ACS receiving ezetimibe in intervention arm, and placebo/active comparator in control arm. Primary outcome was to evaluate changes in LDL-C levels post-ACS. Secondary outcomes were to evaluate alterations in other lipid parameters and adverse events. Results: From initially screened 4561 articles, data from 11 studies (20,291 patients) were analyzed. Compared to controls, patients receiving ezetimibe had significantly lower LDL-C at 7-days [MD -19.55 mg/dl(95 %CI:-36.46 to -2.63);P = 0.02;I 2 = 91 %], 1-month [MD-24.67 mg/dl (95 %CI:-34.59 to -14.76);P < 0.001;I 2 = 81 %], 3-months [MD -18.01 mg/dl(95 %CI:-24.11 to -11.90);P < 0.001;I 2 = 92 %] and 10-12 months [MD -16.90 mg/dl (95 % CI: -17.67 to -16.12); P < 0.001; I 2 = 0 %] of treatment. Compared to controls, patients receiving ezetimibe had significantly lower total cholesterol at 7-days [MD-21.05 mg/dl(95 %CI:-26.73 to -15.37);P < 0.001;I 2 = 0 %], 1-month [MD-25.56 mg/dl(95 %CI:-38.29 to -12.83);P < 0.001;I 2 = 85 %], 3-months [MD-22.54 mg/dl(95 %CI:-36.90 to -8.19);P = 0.002;I 2 = 22 %] and 12-months [MD-19.68 mg/dl(95 %CI:-20.78 to -18.59);P < 0.001;I 2 = 0 %] of treatment. Death from any cause, ACS and non-fatal stroke [OR0.89(95 %CI:0.83-0.96);P = 0.002;I 2 = 0 %], non-fatal myocardial infarction [OR0.86(95 %CI:0.79-0.94);P = 0.001;I 2 = 0 %] and ischemic stroke [OR0.80(95 %CI:0.68-0.94);P = 0.009;I 2 = 0 %] was significantly reduced in patients receiving ezetimibe. Conclusion: Addition of ezetimibe to high-intensity statin therapy at the time of ACS event is associated with significantly better cholesterol reduction at day-7,1-month, 3- months and 1-year of follow-up, which translates into a significantly lower recurrent cardiovascular events post an index event of ACS. Concise Summary of Findings: Addition of ezetimibe to high-intensity statin therapy at the time of acute coronary syndrome (ACS) index event is associated with significantly better low density lipoprotein cholesterol and total cholesterol reduction at day-7, 1-month, 3-months and 1-year of follow-up, which translates into a significantly lower recurrent cardiovascular events (death from any cause, major ACS, non-fatal stroke, non-fatal myocardial infarction, and ischemic stroke) post an index event of ACS. Competing Interests: Declaration of competing interest None. (Copyright © 2024 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Acute coronary syndrome; Ezetimibe; Low-density lipoprotein cholesterol; Meta-analysis |
| المشرفين على المادة: | EOR26LQQ24 (Ezetimibe) 0 (Anticholesteremic Agents) 0 (Cholesterol, LDL) 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) |
| تواريخ الأحداث: | Date Created: 20240209 Date Completed: 20240605 Latest Revision: 20240605 |
| رمز التحديث: | 20240606 |
| DOI: | 10.1016/j.ejim.2024.02.004 |
| PMID: | 38336550 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0828 |
|---|---|
| DOI: | 10.1016/j.ejim.2024.02.004 |