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. 2025 Jan 7;21(1):1-15.
doi: 10.5114/aoms/199826. eCollection 2025.

Rosuvastatin-based combination treatment with acetylsalicylic acid or ezetimibe in the management of patients at high and very high cardiovascular risk. Expert opinion paper of the Polish Lipid Association 2025

Maciej Banach  1   2   3   4 , Stanisław Surma  2   5 , Agata Bielecka-Dąbrowa  2   6 , Marek Gierlotka  7 , Renata Główczynska  8 , Piotr Jankowski  9   10 , Jacek Jóźwiak  11 , Jacek Kubica  12 , Witold Streb  13   14 , Filip M Szymanski  15 , Tomasz Tomasik  16 , Robert Gil  17
Affiliations

Rosuvastatin-based combination treatment with acetylsalicylic acid or ezetimibe in the management of patients at high and very high cardiovascular risk. Expert opinion paper of the Polish Lipid Association 2025

Maciej Banach et al. Arch Med Sci. .

Abstract

Lipid disorders are the most common risk factor for atherosclerotic cardiovascular disease (ASCVD) in Poland, where it is responsible for up to 200,000 deaths per year, with the number of myocardial infarctions and strokes reaching 80,000 annually and 25% of people dying within 3 years after a myocardial infarction. Despite the availability of effective drugs, the level of control of low-density lipoprotein cholesterol (LDL-C) is low, at only about 20% among high- and very high-risk patients, who often require combination lipid-lowering therapy (LLT) with a potent statin (e.g. rosuvastatin) and ezetimibe. Moreover, in Poland, several million patients require concomitant lipid-lowering and antiplatelet (acetylsalicylic acid) therapy based on their risks and indications. Single pill combinations (SPCs) improve adherence to treatment as well as the achievement of therapeutic goals and allow a greater reduction in cardiovascular incidents and mortality. This expert opinion paper, endorsed by the Polish Lipid Association (PoLA), provides practical recommendations for more effective treatment of patients with indications for LLT and antiplatelet therapy using available rosuvastatin-based combination therapies (with ezetimibe or acetylsalicylic acid).

Keywords: cardiovascular risk; combination therapies; ezetimibe; acetylsalicylic acid; primary and secondary prevention; rosuvastatin.

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Conflict of interest statement

Maciej Banach has received grant(s)/research support from Amgen, Daiichi-Sankyo, Mylan/Viatris, and Sanofi and has served as a consultant and/or received speaker’s fees from Adamed, Amgen, Exceed Pharma, Daiichi-Sankyo, Esperion, Kogen, KRKA, Lilly, MSD, Mylan/Viatris, NewAmsterdam Pharma, Novartis, Novo-Nordisk, Polpharma, Sanofi, Teva and Zentiva; Stanislaw Surma has received fees from Novartis/Sandoz, KRKA and Pro.Med; Marek Gierlotka: speaker and/or consulting fees from Adamed, Amgen, Astra-Zeneca, Bayer, Berlin-Chemie Menarini, Boehringer Ingelheim, Merck, Novartis, Novo Nordisk, Promed, Sandoz, Sanofi; Piotr Jankowski has received grant(s)/research support and speaker’s fees from Adamed, Amgen, KRKA, Novartis, Novo-Nordisk, Polpharma, Sanofi, and Zentiva; Jacek Józwiak: has received speaker and/or consulting fees from Valeant, BIO-RAD, Euroimmun, Adamed, Amgen, Boehringer Ingelheim, Teva, Zentiva, Celgene, Servier, Bioton and ALAB; Jacek Kubica: has received speaker and/or consulting fees from Adamed, AstraZeneca, Boehringer Ingelheim, Ferrer, Gedeon Richter and Servier; Tomasz Tomasik has received fees for consulting and educational services from: Biofarm, Adamed, Boehringer, Astra Zeneca, Novo-Nordisk and Teva; Robert Gil: speaker and/or consulting fees from: Amgen, Novartis, AstraZeneca, Boehringer Ingelheim, Gedeon Richter, Pfizer, Servier; all other authors do not declare any conflict of interest.

Figures

Figure 1
Figure 1
Benefits of up-front administration of SPC with a potent statin at the maximum tolerated dose and ezetimibe in a patient with acute coronary syndrome. Study authors based the figure on information from multiple sources [22, 24,25, 47, 49]
Figure 2
Figure 2
Summary of studies on the effect of aspirin use in primary prevention and the ratio of benefits (number needed to treat – NNT) to risks of adverse effects (number needed to harm – NNH). Based on: Della Bona R, Giubilato S, Palmieri M. et al. J Clin Med 2024; 13: 4148. https://doi.org/10.3390/jcm13144148 (reprint permission not required: CC BY licence) [50]
Figure 3
Figure 3
Summary of the Polish Lipid Association (PoLA) recommendations for the use of SPC of rosuvastatin + ASA. Definitions: Should be used (Class I), Should be considered (IIa).
See this image and copyright information in PMC

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