Title:Have We Learnt all from IMPROVE-IT? Part II. Subanalyses of the Effects of Ezetimibe Added to Statin Therapy on Selected Clinical and Laboratory Outcomes, Cost-Effectiveness, Guidelines, and Clinical Implications
Volume: 19
Issue: 5
Author(s): Zlatko Fras*Dimitri P. Mikhailidis
Affiliation:
- Centre for Preventive Cardiology, Department of Vascular Medicine, Division of Medicine, University Medical Centre, Ljubljana,Slovenia
Keywords:
IMPROVE-IT trial, ezetimibe, statin, combination lipid-lowering drug therapy, secondary prevention, costeffectiveness,
safety, lipid-lowering guidelines.
Abstract: In this second part of the review of the IMProved Reduction of Outcomes: Vytorin Efficacy
International Trial (IMPROVE-IT), the findings in relation to patients with stroke, the ACS phenotype,
history of coronary artery bypass graft surgery, heart failure, concurrent polyvascular atherosclerotic
cardiovascular disease (ASCVD) and diabetes mellitus, and different levels of expression of selected
cardiovascular biomarkers, are discussed. The combination therapy was proven safe, and drug discontinuation
rates were not increased by adding ezetimibe. Since both statins and ezetimibe are now almost
globally generically available, it can be concluded that for secondary prevention of ASCVD, adding
ezetimibe to high-intensity statin therapy further reduces low-density lipoprotein cholesterol (LDL-C)
and cardiovascular risk, cost-effectively.