Every 33 seconds one person dies from cardiovascular disease, according to the Centers for Disease Control and Prevention (CDC). In a single year, an estimated 805,000 Americans will suffer from a heart attack. While diet and exercise can help prevent a cardiovascular event, many doctors will also prescribe their patients a cholesterol-lowering statin. However, researchers believe they’ve uncovered the new "gold standard" of treatment for high-risk patients.
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Lower levels of "bad" cholesterol are linked to a new statin combination therapy.
There’s "good" and "bad" cholesterol, the latter of which refers to low-density lipoprotein (LDL) cholesterol. This kind builds up in your arteries, making them hard and narrow, according to Mayo Clinic. In more advanced cases, the plaque buildup can restrict blood flow and trigger a heart attack or stroke. That’s why many people go on statins.
Statins are a cholesterol-lowering medication that "decrease your triglycerides and help your liver get rid of more cholesterol" while also increasing your "good" cholesterol levels, per Cleveland Clinic. In the health world, statins are the number-one defense against high cholesterol.
However, experts now say incorporating a drug called ezetimibe could be the new "gold standard." Ezetimibe is prescribed to keep the "small intestine from absorbing cholesterol." explains Cleveland Clinic. Together, statins and ezetimibe have proven to be a lot more effective.
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Together, statins and ezetimibe reduced cardiovascular events and cholesterol-related death.
A comprehensive meta-analysis involving 108,353 high-risk heart attack/stroke patients found that combination therapy can reduce cholesterol-related deaths by 49 percent. The results, which were published in the journal Mayo Clinic Proceedings, suggest that a statin-ezetimibe treatment plan could not only prevent life-threatening cardiovascular events and mortality but also improve levels of LDL-C.
For the study, "high-risk patients" were defined as individuals who had already suffered from a heart attack or stroke, or whose risk probability was deemed high by professionals. Compared to statin-only therapy, the drug combination showed a:
- 19 percent decrease in overall death
- 16 percent decrease in cardiovascular-related death
- 18 percent decrease in major cardiovascular events, including stroke
- 13 mg/dL decrease in LDL-C levels
Together, statins and ezetimibe enabled participants to get their LDL-C levels back on track (under the recommended 70 mg/DL mark). Improvements spiked by 85 percent, per their findings.
"These results were even more pronounced in the network meta-analysis, which enables a direct comparison of different therapy regimens used in the study," lead author Maciej Banach, PhD, who served as chairman of the International Lipid Expert Panel and the Blood Pressure Meta-analysis Collaboration group that conducted the study, told SciTechDaily. "This showed a 49 percent reduction in all-cause mortality and a 39 percent reduction in major adverse cardiovascular events, when compared to high dose statin therapy alone."
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The takeaway:
According to the study, combined statin therapy can prevent heart attack, stroke, and even mortality among high-risk patients with poor LDL-C levels. While statins by themselves are the preferred method of treatment, introducing ezetimibe can lead to more significant improvements.
"This study confirms that combined cholesterol lowering therapy should be considered immediately and should be the gold standard for treatment of very high-risk patients after an acute cardiovascular event," co-author Peter Toth, PhD, a family medicine professor at the University of Illinois, told SciTechDaily.
"This approach does not require additional funding or reimbursement of new expensive drugs," Toth added. "In fact, it may translate into lower rates of first and subsequent heart attacks and stroke, and their complications like heart failure, which are extremely costly for all healthcare systems."
