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Randomized Controlled Trial
. 2017 Jun 20;8(25):41582-41589.
doi: 10.18632/oncotarget.15078.

Therapeutic effects of atorvastatin and ezetimibe compared with double-dose atorvastatin in very elderly patients with acute coronary syndrome

Zhi Liu  1 , Hengjian Hao  1 , Chunlin Yin  1 , Yanyan Chu  1 , Jing Li  1 , Dong Xu  1
Affiliations
Randomized Controlled Trial

Therapeutic effects of atorvastatin and ezetimibe compared with double-dose atorvastatin in very elderly patients with acute coronary syndrome

Zhi Liu et al. Oncotarget. .

Abstract

Objective Compared the effect of atorvastatin 10 mg combined ezetimibe 10 mg therapy with atorvastatin 20 mg on the long-term outcomes in very elderly patients with acute coronary syndrome.Methods A total of 230 octogenarian patients with acute coronary syndrome underwent coronary angiography were randomized to combined therapy group (atorvastatin 10 mg/d and ezetimibe 10 mg/d, n=114) or double-dose atorvastatin group (atorvastatin 20mg/d, n=116). The primary end point was one-year incidence of major adverse cardiovascular events (including cardiac death, spontaneous myocardial infarction, unplanned revascularization).Result At the end of one year, the percentage of patients with low-density lipoprotein cholesterol level decreased more than 30% or 50% were comparable between the two groups (93.5% vs. 90.1%, p= 0.36; 54.6% vs. 49.6%, p= 0.45). The rate of major adverse cardiovascular events in combined therapy group was similar with double-dose atorvastatin group (23.2% vs. 19.8%, p=0.55). In COX regression model, the risk of major adverse cardiovascular events in combined group isn't significantly higher than double-dose atorvastatin group (HR [95% CI] 1.12 [0.51 to 2.55], p = 0.74). The patients whose alanine aminotransferase increasing more than upper normal limit in combined group was lower than double-dose atorvastatin group (2.8% vs. 9.0%, p = 0.05).Conclusions For very elderly patients with acute coronary syndrome, atorvastatin combining ezetimibe induced similar long-term outcomes compared with double-dose atorvastatin but with less liver dysfunction.

Keywords: acute coronary syndrome; atorvastatin; elderly; ezetimibe; prognosis.

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Conflict of interest statement

CONFLICTS OF INTEREST

The study was not supported by any external source of funding. There are no relationships with industry. All authors have nothing to declare.

Figures

Figure 1
Figure 1. Unadjusted Kaplan-Meier curves for MACE of the two groups in one-year follow-up
The event rate of MACE in combined therapy group was similar with double-dose atorvastatin group. MACE, major adverse cardiovascular events, including cardiac death, spontaneous myocardial infarction, unplanned revascularization.
See this image and copyright information in PMC

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