The effect of combined ezetimibe and statin therapy versus statin therapy alone on coronary plaque volume assessed by intravascular ultrasound

A systematic review and meta-analysis

Sam Mirzaee, Paul Paw Min Thein, Jason Nogic, Nitesh Nerlekar, Arthur Nasis, Adam John Dunbar Brown

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Background: Current guidelines recommend an intensive lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) target in patients with high risk of cardiovascular disease. Former studies suggested adding ezetimibe to statin therapy in the above setting may promote plaque changes; however, this effect has not been consistently reported. Methods: Electronic searches were performed in MEDLINE, EMBASE, and Cochrane library on November 30, 2017 to identify prospective trials assessing the effects of combined ezetimibe and statin therapy versus statin therapy alone on atheroma volume using intravascular ultrasound. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random-effects model. Results: Eight studies were obtained for systematic review and 6 of them compromising total of 583 subjects that meet the criteria were meta-analyzed. There was a significant reduction from baseline to follow-up in total atheroma volume with an MD of –3.71 mm3 (95% confidence interval: −5.98 to −1.44, P <.001), whereas analysis for percent atheroma volume demonstrated weighted MD of – 0.77% (−1.68 to 0.14, P =.10). A substantial decrease in LDL-C was observed with MD −16.75 mg/dL (−20.89 to −12.60, P <.00001). Conclusion: The addition of ezetimibe to statin therapy is effective in reducing total atheroma volume assessed by intravascular ultrasound and also resulted in effective reduction of plasma LDL-C levels.

Original languageEnglish
Pages (from-to)1133-1140.e15
Number of pages23
JournalJournal of Clinical Lipidology
Volume12
Issue number5
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • Coronary atherosclerotic plaque
  • Ezetimibe therapy
  • Intravascular ultrasound
  • Statin

Cite this

@article{e272a018f58d4f60a3ea1f1cfdf813c7,
title = "The effect of combined ezetimibe and statin therapy versus statin therapy alone on coronary plaque volume assessed by intravascular ultrasound: A systematic review and meta-analysis",
abstract = "Background: Current guidelines recommend an intensive lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) target in patients with high risk of cardiovascular disease. Former studies suggested adding ezetimibe to statin therapy in the above setting may promote plaque changes; however, this effect has not been consistently reported. Methods: Electronic searches were performed in MEDLINE, EMBASE, and Cochrane library on November 30, 2017 to identify prospective trials assessing the effects of combined ezetimibe and statin therapy versus statin therapy alone on atheroma volume using intravascular ultrasound. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random-effects model. Results: Eight studies were obtained for systematic review and 6 of them compromising total of 583 subjects that meet the criteria were meta-analyzed. There was a significant reduction from baseline to follow-up in total atheroma volume with an MD of –3.71 mm3 (95{\%} confidence interval: −5.98 to −1.44, P <.001), whereas analysis for percent atheroma volume demonstrated weighted MD of – 0.77{\%} (−1.68 to 0.14, P =.10). A substantial decrease in LDL-C was observed with MD −16.75 mg/dL (−20.89 to −12.60, P <.00001). Conclusion: The addition of ezetimibe to statin therapy is effective in reducing total atheroma volume assessed by intravascular ultrasound and also resulted in effective reduction of plasma LDL-C levels.",
keywords = "Coronary atherosclerotic plaque, Ezetimibe therapy, Intravascular ultrasound, Statin",
author = "Sam Mirzaee and Thein, {Paul Paw Min} and Jason Nogic and Nitesh Nerlekar and Arthur Nasis and Brown, {Adam John Dunbar}",
year = "2018",
month = "9",
day = "1",
doi = "10.1016/j.jacl.2018.06.001",
language = "English",
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pages = "1133--1140.e15",
journal = "Journal of Clinical Lipidology",
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The effect of combined ezetimibe and statin therapy versus statin therapy alone on coronary plaque volume assessed by intravascular ultrasound : A systematic review and meta-analysis. / Mirzaee, Sam; Thein, Paul Paw Min; Nogic, Jason; Nerlekar, Nitesh; Nasis, Arthur; Brown, Adam John Dunbar.

In: Journal of Clinical Lipidology, Vol. 12, No. 5, 01.09.2018, p. 1133-1140.e15.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - The effect of combined ezetimibe and statin therapy versus statin therapy alone on coronary plaque volume assessed by intravascular ultrasound

T2 - A systematic review and meta-analysis

AU - Mirzaee, Sam

AU - Thein, Paul Paw Min

AU - Nogic, Jason

AU - Nerlekar, Nitesh

AU - Nasis, Arthur

AU - Brown, Adam John Dunbar

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Current guidelines recommend an intensive lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) target in patients with high risk of cardiovascular disease. Former studies suggested adding ezetimibe to statin therapy in the above setting may promote plaque changes; however, this effect has not been consistently reported. Methods: Electronic searches were performed in MEDLINE, EMBASE, and Cochrane library on November 30, 2017 to identify prospective trials assessing the effects of combined ezetimibe and statin therapy versus statin therapy alone on atheroma volume using intravascular ultrasound. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random-effects model. Results: Eight studies were obtained for systematic review and 6 of them compromising total of 583 subjects that meet the criteria were meta-analyzed. There was a significant reduction from baseline to follow-up in total atheroma volume with an MD of –3.71 mm3 (95% confidence interval: −5.98 to −1.44, P <.001), whereas analysis for percent atheroma volume demonstrated weighted MD of – 0.77% (−1.68 to 0.14, P =.10). A substantial decrease in LDL-C was observed with MD −16.75 mg/dL (−20.89 to −12.60, P <.00001). Conclusion: The addition of ezetimibe to statin therapy is effective in reducing total atheroma volume assessed by intravascular ultrasound and also resulted in effective reduction of plasma LDL-C levels.

AB - Background: Current guidelines recommend an intensive lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) target in patients with high risk of cardiovascular disease. Former studies suggested adding ezetimibe to statin therapy in the above setting may promote plaque changes; however, this effect has not been consistently reported. Methods: Electronic searches were performed in MEDLINE, EMBASE, and Cochrane library on November 30, 2017 to identify prospective trials assessing the effects of combined ezetimibe and statin therapy versus statin therapy alone on atheroma volume using intravascular ultrasound. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random-effects model. Results: Eight studies were obtained for systematic review and 6 of them compromising total of 583 subjects that meet the criteria were meta-analyzed. There was a significant reduction from baseline to follow-up in total atheroma volume with an MD of –3.71 mm3 (95% confidence interval: −5.98 to −1.44, P <.001), whereas analysis for percent atheroma volume demonstrated weighted MD of – 0.77% (−1.68 to 0.14, P =.10). A substantial decrease in LDL-C was observed with MD −16.75 mg/dL (−20.89 to −12.60, P <.00001). Conclusion: The addition of ezetimibe to statin therapy is effective in reducing total atheroma volume assessed by intravascular ultrasound and also resulted in effective reduction of plasma LDL-C levels.

KW - Coronary atherosclerotic plaque

KW - Ezetimibe therapy

KW - Intravascular ultrasound

KW - Statin

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U2 - 10.1016/j.jacl.2018.06.001

DO - 10.1016/j.jacl.2018.06.001

M3 - Review Article

VL - 12

SP - 1133-1140.e15

JO - Journal of Clinical Lipidology

JF - Journal of Clinical Lipidology

SN - 1933-2874

IS - 5

ER -