Intensified lipid lowering using ezetimibe after publication of the IMPROVE-IT trial: A contemporary analysis from the SPUM-ACS cohort.

Details

Serval ID
serval:BIB_6FD93ED5EC69
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intensified lipid lowering using ezetimibe after publication of the IMPROVE-IT trial: A contemporary analysis from the SPUM-ACS cohort.
Journal
International journal of cardiology
Author(s)
Gencer B., Carballo D., Nanchen D., Koskinas K.C., Klingenberg R., Räber L., Auer R., Carballo S., Heg D., Windecker S., Lüscher T.F., Matter C.M., Rodondi N., Mach F.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
15/03/2020
Peer-reviewed
Oui
Volume
303
Pages
8-13
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The relevance of the IMPROVE-IT trial on real-life practice has not been explored in patients with ACS.
A prospective Swiss cohort of 6266 patients hospitalized for ACS between 2009 and 2017 with a one-year follow-up. The primary endpoints were the ezetimibe use overall or in combination with high-intensity statin at discharge and at one year after ACS. Secondary endpoint was LDL-C target achievement at one year in a subsample of 2984 patients. Relative Ratios (RR) were used to assess changes in primary endpoints before and after the publication of IMPROVE-IT, adjusting for age, sex, diabetes, prior myocardial infarction, LDL-C and attendance to cardiac rehabilitation.
The period following the publication of the IMPROVE-IT trial was associated with a steady increase in the use of ezetimibe at discharge (from 1.8% to 3.8%, P < 0.001, adjusted RR 2.85, 95% CI 1.90-4.25) and at one year (from 5.0% to 13.8%, P < 0.001, adjusted RR 3.00, 95% CI 2.40-3.75). The combination of high-intensity statin and ezetimibe rose from 0.9% to 2.1% at discharge (P < 0.001, adjusted RR 3.35, 95% CI 1.90-5.89) and from 2.1% to 7.8% at one year (P < 0.001, adjusted RR 3.98, 95% CI 2.90-5.47). The period following the publication of the IMPROVE-IT trial was associated with an improvement of LDL-C target <1.8 mmol/L (adjusted RR 1.37, 95% CI 1.12-1.68).
After the publication of the IMPROVE-IT trial, the use of ezetimibe was increased by three-fold in a large contemporary cohort of ACS patients, concomitant with an improved LDL-C target achievement.
Keywords
Acute coronary syndromes, Ezetimibe, Guidelines, Lipids, Statin
Pubmed
Web of science
Create date
03/01/2020 17:12
Last modification date
18/09/2020 6:26
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